{"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":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"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":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":136.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":494.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":395.37,"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"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.53,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.96,"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"]},{"negotiated_type":"negotiated","negotiated_rate":153.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":340.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":216.76,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","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"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.98,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.89,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"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":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3028.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.17,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6977.28,"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":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":1721.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.3,"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":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.4,"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":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.14,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1053.04,"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":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":204.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including 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":"percentage","negotiated_rate":20.0,"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":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.16,"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":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.97,"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":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.6,"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":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":146.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.03,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"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":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":195.35,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.77,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.59,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":320.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.69,"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":"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.76,"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":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.15,"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":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.09,"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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.42,"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":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.77,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":522.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"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":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":177.06,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.99,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"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":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"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"]},{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97154","name":"Grp adapt bhv tx by tech","description":"Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.45,"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":171.4,"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"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1274.45,"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":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.23,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.23,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.64,"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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.77,"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":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.71,"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":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":161.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.49,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"S9446","name":"Pt education noc group","description":"Patient education, not otherwise classified, non-physician provider, group, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.61,"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":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":95.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","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":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":147.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":181.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":739.64,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.14,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.84,"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":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.95,"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":"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":70.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.19,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.35,"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.4,"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":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.06,"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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2635.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.14,"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":"G9919","name":"Scrn nd pos nd prov of rec","description":"Screening performed and positive and provision of recommendations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"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":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.3,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.01,"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":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.74,"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":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.81,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.02,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.86,"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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.96,"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":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9445","name":"Pt education noc individ","description":"Patient education, not otherwise classified, non-physician provider, individual, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.87,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"13020","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.96,"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"]},{"negotiated_type":"negotiated","negotiated_rate":347.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.41,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.54,"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":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.02,"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":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0436","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.99,"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":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.04,"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":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.02,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.12,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.39,"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":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.77,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.21,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":624.49,"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":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.06,"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":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.64,"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":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.6,"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":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.67,"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":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":76.13,"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":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.51,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":120.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":109.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.82,"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":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.49,"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":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 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":"percentage","negotiated_rate":20.0,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.97,"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":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.8,"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":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.12,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.35,"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":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":125.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.97,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81241","name":"F5 gene","description":"F5 (coagulation factor v) (eg, hereditary hypercoagulability) gene analysis, leiden variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.79,"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":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.25,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.41,"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":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10047","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":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.06,"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":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":192.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.02,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.55,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.17,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.68,"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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.63,"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":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":38.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.78,"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":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.74,"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":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.69,"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":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":771.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.83,"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":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.11,"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":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.63,"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":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"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":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"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":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.72,"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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.31,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.56,"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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":152.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.39,"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":412.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81207","name":"Bcr/abl1 gene minor bp","description":"Bcr/abl1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; minor breakpoint, qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.69,"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":"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":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.87,"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":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.31,"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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.27,"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"]},{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.61,"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":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["U1"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.49,"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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"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":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.27,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.27,"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":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":305.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":233.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1015.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.95,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":357.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TS","T1"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","zip":"10047","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":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.41,"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":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.12,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.1,"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":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.52,"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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.76,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":261.03,"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":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":198.53,"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":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.74,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.02,"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":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.95,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":217.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.31,"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":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.27,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.11,"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":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.19,"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":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.58,"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":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.88,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.3,"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":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.17,"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":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.51,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":74.04,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.45,"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":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.21,"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":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.67,"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":70.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":23.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.29,"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":"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":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.99,"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":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":235.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.21,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.24,"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":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"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":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TU"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":72.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1832.73,"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":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.41,"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":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.83,"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":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":406.42,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.29,"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":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1264.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2942.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2058.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.55,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2073.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.52,"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":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64463","name":"Pvb thoracic cont infusion","description":"Paravertebral block (pvb) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.68,"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":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.55,"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":"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":"1320201","zip":"10001","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":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":223.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.17,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.35,"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":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.71,"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":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.01,"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":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":43.67,"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":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.33,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.6,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":30.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.25,"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.78,"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":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.52,"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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":291.56,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.31,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.71,"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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.07,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":12.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":136.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":291.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"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":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.65,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3734.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.1,"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":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.49,"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":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.72,"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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.71,"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":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.62,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3315.39,"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":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.4,"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":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.89,"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":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":66.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.56,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.06,"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":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.12,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.74,"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":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.76,"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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.46,"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"]}],"provider_references":[4]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.58,"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"]},{"negotiated_type":"negotiated","negotiated_rate":23.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.15,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":2679.15,"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":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82681","name":"Assay dir meas fr estradiol","description":"Estradiol; free, direct measurement (eg, equilibrium dialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.94,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]},{"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.71,"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":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":500.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":409.97,"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"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.02,"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":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.39,"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":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":80.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.65,"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"]}],"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":28.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":51.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.82,"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":"G8431","name":"Pos clin depres scrn f/u doc","description":"Screening for depression is documented as being positive and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.77,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.13,"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":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.54,"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":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.77,"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":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"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":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.74,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic 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":"percentage","negotiated_rate":20.0,"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":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.53,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":[2]}]},{"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":"13020","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80346","name":"Benzodiazepines1-12","description":"Benzodiazepines; 1-12","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.97,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.86,"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":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.84,"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":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.41,"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":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.91,"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":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.28,"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":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.92,"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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.59,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":143.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.8,"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":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":156.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4403.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.33,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":141.21,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.66,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1710.71,"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":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.06,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"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":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":123.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.12,"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":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.29,"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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.45,"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":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":188.43,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":114.05,"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"]},{"negotiated_type":"negotiated","negotiated_rate":186.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","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":[2]}]},{"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":34.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.33,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.6,"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":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.84,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.87,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":215.52,"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":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":134.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.45,"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":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.94,"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":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.13,"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"]},{"negotiated_type":"negotiated","negotiated_rate":634.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10985","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2777.56,"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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.31,"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":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.91,"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":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"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":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.19,"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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.68,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.45,"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":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":4.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.41,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.78,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.93,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81212","name":"Brca1&2 185&5385&6174 vrnt","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; 185delag, 5385insc, 6174delt variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.0,"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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.21,"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":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"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":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.95,"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":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"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":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":2345.45,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.6,"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":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":991.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.76,"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":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.61,"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":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.26,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.87,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.84,"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":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.08,"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":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":62.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.46,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.67,"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"]},{"negotiated_type":"negotiated","negotiated_rate":113.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"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":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HH"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with 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":"percentage","negotiated_rate":20.0,"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":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":100.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.2,"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":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.49,"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":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.23,"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":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1602.89,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.65,"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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.51,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.27,"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":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":125.39,"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"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.06,"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":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":106.71,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":38.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.45,"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":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":477.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.07,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.17,"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":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":360.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0209","name":"Wc van mileage per mi","description":"Wheelchair van, mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["HE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":119.54,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.95,"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":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":46.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":3806.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.12,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"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":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.75,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.12,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.26,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.72,"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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.58,"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":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.72,"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":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.94,"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":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":711.39,"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":144.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.15,"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":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","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":[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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.8,"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":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.01,"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":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.5,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.6,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":1291.31,"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":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4107.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":167.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":193.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.4,"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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.02,"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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.45,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.53,"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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.15,"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":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2908.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.28,"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":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with 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":"percentage","negotiated_rate":20.0,"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":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.25,"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"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":153.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.45,"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":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.83,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.2,"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":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.72,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.91,"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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.08,"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":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"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":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.1,"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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.63,"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":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80210","name":"Drug assay rufinamide","description":"Rufinamide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3821.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.99,"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":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":187.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.83,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.4,"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":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.43,"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":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":97.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10501","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":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["KF"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3827.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":991.91,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.36,"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":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.43,"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"]},{"negotiated_type":"negotiated","negotiated_rate":126.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.31,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.08,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.68,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.68,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":414.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.87,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.32,"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":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":92.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.36,"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":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":2906.49,"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":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.27,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":453.49,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":17.27,"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":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.19,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.31,"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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.83,"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":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"13020","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":288.95,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.41,"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.3,"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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80353","name":"Drug screening cocaine","description":"Cocaine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.43,"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"]},{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":50.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.11,"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":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.75,"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":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":575.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":77.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.59,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 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":"percentage","negotiated_rate":20.0,"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.91,"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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.43,"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":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.56,"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":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.71,"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":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1714.19,"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":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"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"]},{"negotiated_type":"negotiated","negotiated_rate":23.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":51.7,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":416.91,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.09,"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":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":693.25,"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":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.11,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.86,"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":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.94,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.34,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.69,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.12,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.42,"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":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.78,"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":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.43,"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":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2005","name":"N-et; stretcher van","description":"Non-emergency transportation; stretcher van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.67,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.24,"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":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.89,"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":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":104.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.6,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.15,"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":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.6,"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":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.06,"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":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80347","name":"Benzodiazepines 13 or more","description":"Benzodiazepines; 13 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.49,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.89,"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":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"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":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":230.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1433.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"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":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.29,"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80365","name":"Drug screening oxycodone","description":"Oxycodone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.5,"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":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.8,"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":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.77,"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":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":15.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.42,"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.59,"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"]},{"negotiated_type":"negotiated","negotiated_rate":104.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.41,"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":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":156.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.63,"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":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.81,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.53,"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":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.75,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.73,"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":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.27,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.2,"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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.27,"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":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.03,"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":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.57,"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":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.55,"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":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":32.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":52.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":74.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.01,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.01,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.32,"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":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":182.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":168.16,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81361","name":"Hbb gene com variants","description":"Hbb (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, hbs, hbc, hbe)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.08,"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":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.33,"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"]}],"provider_references":[3]}]},{"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","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":458.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":665.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":55.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.57,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.11,"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":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.53,"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":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.54,"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":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":155.9,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","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":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.14,"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":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.74,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.42,"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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.23,"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"]},{"negotiated_type":"negotiated","negotiated_rate":92.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":15.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.84,"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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"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":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.33,"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":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":89.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"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":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.21,"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"]},{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"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":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.52,"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":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":360.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":167.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":491.64,"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":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.57,"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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.53,"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":"S5561","name":"Insulin reuse pen 3 ml","description":"Insulin delivery device, reusable pen; 3 ml size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"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":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":269.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.17,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5399.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.97,"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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.46,"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"]},{"negotiated_type":"negotiated","negotiated_rate":166.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.58,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.79,"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":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81508","name":"Ftl cgen abnor two proteins","description":"Fetal congenital abnormalities, biochemical assays of two proteins (papp-a, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.3,"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":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":1591.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":54.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.99,"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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.34,"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":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.43,"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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10047","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":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":87.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.01,"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":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.72,"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":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.06,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.04,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":11755.04,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.01,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.75,"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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.26,"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":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10501","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":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":119.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.86,"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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":452.11,"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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.32,"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":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"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":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.48,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.23,"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":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":50.77,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"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":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.78,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.5,"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":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4959.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.53,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.29,"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":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":5.23,"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":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.83,"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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.22,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.51,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.05,"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":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":308.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.85,"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":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":362.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.86,"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":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.67,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"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":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.77,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.34,"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":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.41,"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":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.65,"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":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4023.73,"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":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.11,"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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":185.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80364","name":"Opioid &opiate analog 5/more","description":"Opioids and opiate analogs; 5 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":217.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.2,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13143","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.39,"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":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.91,"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":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":133.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":61.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.66,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.27,"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":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.44,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":975.34,"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":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["LR"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80193","name":"Drug assay leflunomide","description":"Leflunomide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"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":"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":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.6,"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":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":164.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.12,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.56,"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":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"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":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.26,"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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.29,"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":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81227","name":"Cyp2c9 gene com variants","description":"Cyp2c9 (cytochrome p450, family 2, subfamily c, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.4,"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":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1874.5,"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":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":178.38,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.79,"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":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.05,"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":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.68,"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":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.81,"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"]},{"negotiated_type":"negotiated","negotiated_rate":3345.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"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":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":9.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":253.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.32,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.16,"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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"10047","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.58,"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":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.98,"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":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87806","name":"Hiv ag w/hiv1&2 antb w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"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":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":156.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":166.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.41,"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":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":23.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"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":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1199.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.41,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.88,"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S0580","name":"Polycarb lens","description":"Polycarbonate lens (list this code in addition to the basic code for the lens)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.73,"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":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.11,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.58,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81240","name":"F2 gene","description":"F2 (prothrombin, coagulation factor ii) (eg, hereditary hypercoagulability) gene analysis, 20210g>a variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.69,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.32,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":20.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.19,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.75,"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":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.14,"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":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10910","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":138.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.39,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.63,"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":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":841.41,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":104.12,"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":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.66,"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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.2,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"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":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"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":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"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":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"10047","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D6105","name":"Remove implant body","description":"Remove implant body","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.32,"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":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.83,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.56,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2361.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":103.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"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":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.32,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":73.38,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.41,"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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2005","name":"N-et; stretcher van","description":"Non-emergency transportation; stretcher van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TN"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.41,"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":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.49,"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":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.94,"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"]}],"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","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.66,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.27,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.04,"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":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-06","zip":"10047","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.0,"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":"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":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.31,"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":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.51,"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":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.84,"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":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":21.04,"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","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.57,"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":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":81.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":85.23,"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"]},{"negotiated_type":"negotiated","negotiated_rate":143.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":101.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":37.12,"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":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.26,"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":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.9,"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":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.8,"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":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93566","name":"Njx car cth slctv rv/ra ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.79,"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":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.4,"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":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.9,"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":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.78,"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":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"14001","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"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"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":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":393.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.26,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","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":[2]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.79,"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":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.24,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81595","name":"Cardiology hrt trnspl mrna","description":"Cardiology (heart transplant), mrna, gene expression profiling by real-time quantitative pcr of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3240.0,"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":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.69,"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":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3782.6,"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":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.43,"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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":46.77,"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":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.65,"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":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":322.83,"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":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.53,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.04,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.71,"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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.64,"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.13,"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":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.56,"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4335","name":"Incontinence supply","description":"Incontinence supply; miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.6,"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":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.29,"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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.81,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1317.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.5,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.64,"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":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.08,"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":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81519","name":"Oncology breast mrna","description":"Oncology (breast), mrna, gene expression profiling by real-time rt-pcr of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3873.0,"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":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.57,"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":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.74,"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":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":164.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (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":"percentage","negotiated_rate":20.0,"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":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.99,"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":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.49,"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":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"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":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.33,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"14001","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":[5]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.8,"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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.67,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.01,"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":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.47,"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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"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":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1070.39,"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":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1093.78,"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":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.64,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.67,"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":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"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":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.54,"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":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.23,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":30.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.2,"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.16,"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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.04,"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":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.68,"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":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":115.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.14,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.24,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":35.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.67,"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":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":59.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.67,"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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.55,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.49,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"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":"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":"1328299","zip":"12007","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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":491.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"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":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.14,"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":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.78,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.65,"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":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.28,"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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.14,"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":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.99,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.97,"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":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.01,"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":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.64,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":45.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":130.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"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":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10047","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.01,"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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.25,"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"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":"37220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.32,"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":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.83,"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":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.91,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81297","name":"Msh2 gene dup/delete variant","description":"Msh2 (muts homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.3,"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":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.39,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4151.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.83,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.66,"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":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.13,"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":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1451.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80187","name":"Drug assay posaconazole","description":"Posaconazole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.82,"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":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.8,"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":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.07,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.09,"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":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1230.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.94,"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":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.38,"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":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.53,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2928.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"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":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":169.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":522.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.73,"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"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.69,"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"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":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99429","name":"Unlisted preventive service","description":"Unlisted preventive medicine service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":302.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.46,"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":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.53,"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":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":81.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"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":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.33,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.66,"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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.22,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":1454.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":120.31,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":211.46,"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":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.78,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.96,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.43,"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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":127.54,"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":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.57,"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":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.46,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10301","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":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10301","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":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10910","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":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.86,"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":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.16,"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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.56,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.82,"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":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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","zip":"13143","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.4,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.72,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.79,"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":"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.41,"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":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.58,"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":"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":"percentage","negotiated_rate":20.0,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.17,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.27,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.72,"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":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":5.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.2,"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":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.72,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":593.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.43,"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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.89,"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.67,"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.4,"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":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.06,"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":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.63,"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"]},{"negotiated_type":"negotiated","negotiated_rate":196.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.93,"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":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.37,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.73,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.65,"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":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.83,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":7671.15,"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":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.26,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.52,"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":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":63.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.36,"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.12,"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":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4668.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, 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":"percentage","negotiated_rate":20.0,"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":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.63,"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":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81332","name":"Serpina1 gene","description":"Serpina1 (serpin peptidase inhibitor, clade a, alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *s and *z)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10985","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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.16,"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":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.53,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.19,"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":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.67,"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":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.24,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":102.34,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2791.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":153.44,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.56,"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"]},{"negotiated_type":"negotiated","negotiated_rate":88.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.86,"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":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":85.98,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.78,"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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.4,"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":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":147.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":160.13,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":148.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":214.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.48,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.79,"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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.46,"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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81339","name":"Mpl gene seq alys exon 10","description":"Mpl (mpl proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.76,"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":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"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":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":77.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":338.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":2747.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.21,"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":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.86,"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":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.29,"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":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"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":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.79,"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":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.31,"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":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.13,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7178.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":151.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":242.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.03,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.45,"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":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":164.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.25,"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":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.67,"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":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","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":[2]}]},{"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","zip":"14001","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"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.08,"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":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.67,"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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.01,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial 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":"percentage","negotiated_rate":20.0,"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":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7620.25,"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":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"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","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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.29,"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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial 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":"percentage","negotiated_rate":20.0,"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":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.52,"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.17,"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"]},{"negotiated_type":"negotiated","negotiated_rate":119.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.76,"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":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.79,"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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.87,"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":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.15,"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":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":257.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.61,"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":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.45,"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":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81191","name":"Ntrk1 translocation analysis","description":"Ntrk1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"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":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.69,"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":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":57.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":330.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.25,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.31,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":25.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"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":107.98,"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":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.17,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1650.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":91.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":99.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":315.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.27,"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":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.73,"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":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":190.81,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.2,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.37,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.49,"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":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.32,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.88,"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":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.83,"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":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.49,"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":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10301","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":[7]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":1889.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.5,"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":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.36,"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":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.28,"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":"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.31,"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":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.27,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.36,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.09,"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":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10047","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.12,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.52,"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":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":102.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.31,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.75,"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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":44.29,"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":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4097.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":176.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.0,"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.23,"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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.34,"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":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.23,"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":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.13,"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":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":58.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional 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":"percentage","negotiated_rate":20.0,"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":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.63,"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":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HK"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.21,"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"]},{"negotiated_type":"negotiated","negotiated_rate":126.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.06,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.94,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2555.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":830.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.76,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":81.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1874.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":181.58,"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.75,"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":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":835.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":39.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.52,"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":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.25,"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":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.59,"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":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.56,"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":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":153.55,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.86,"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":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.55,"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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.15,"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":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":11.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.43,"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":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2229.97,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.54,"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.43,"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":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.31,"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":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":52.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":358.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":35.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.29,"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":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80367","name":"Drug screening propoxyphene","description":"Propoxyphene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.23,"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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"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":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":130.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.14,"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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":81.1,"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":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.08,"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":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"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":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.09,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.61,"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":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.12,"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":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.88,"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":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.42,"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":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"10047","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.56,"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":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.54,"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":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37188","name":"Ven mechnl thrmbc repeat tx","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":38.54,"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":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.44,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.83,"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":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.51,"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":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"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":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.84,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":71.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.21,"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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HH"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":146.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":148.32,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.69,"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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"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":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.31,"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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.49,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.73,"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":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.52,"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":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":259.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":88.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1320203","zip":"10512","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":[3]}]},{"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":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason 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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.82,"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":"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":"14001","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":[5]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81269","name":"Hba1/hba2 gene dup/del vrnts","description":"Hba1/hba2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, hb bart hydrops fetalis syndrome, hbh disease), gene analysis; duplication/deletion variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.4,"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":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":188.43,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.22,"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":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.01,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.69,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.25,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":170.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"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":441.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"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":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.35,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.11,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1725.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":261.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7.42,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.61,"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":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.3,"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":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.45,"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":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.43,"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":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.14,"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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":223.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.94,"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":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.26,"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":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.49,"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":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":122.34,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.24,"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":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.85,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":42.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.86,"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":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.4,"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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.8,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.19,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":199.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex 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":"percentage","negotiated_rate":20.0,"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":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","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":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":43.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":46.91,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.73,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":19.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TG"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"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":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HA","HC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.69,"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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.0,"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":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.03,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.07,"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"]},{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"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":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.74,"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":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2067.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.35,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.52,"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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.85,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"10501","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":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.18,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.15,"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":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80336","name":"Antidepressant tricyclic 3-5","description":"Antidepressants, tricyclic and other cyclicals; 3-5","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1862.04,"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":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.36,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"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":"10301","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":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7153.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.82,"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":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.95,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.51,"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":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.16,"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":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.02,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.95,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2589.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.69,"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"]}],"provider_references":[4]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80183","name":"Drug scrn quant oxcarbazepin","description":"Oxcarbazepine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.78,"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":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":9.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.39,"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":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.65,"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":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"10910","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":157.11,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":233.01,"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":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"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":"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":"percentage","negotiated_rate":20.0,"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":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.71,"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":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2674.15,"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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.75,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.08,"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":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":381.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; 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":"percentage","negotiated_rate":20.0,"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":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.82,"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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"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":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.93,"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":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":120.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":54.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.95,"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"]},{"negotiated_type":"negotiated","negotiated_rate":216.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.45,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.89,"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":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.27,"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":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":2024.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.84,"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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.14,"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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.98,"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.53,"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":"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.72,"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":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":185.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":38.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":67.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.37,"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":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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","zip":"10501","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":[6]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["GT","HE","FQ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.33,"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":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.14,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61797","name":"Srs cran les simple addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.34,"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":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2229.97,"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":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"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":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.95,"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":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.77,"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":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.98,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.72,"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":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TK"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU","AV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.27,"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":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":1606.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":862.97,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.46,"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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.86,"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":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.86,"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":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.25,"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":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.65,"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":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.39,"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":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.42,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":666.42,"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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":155.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.85,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.9,"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"]},{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.39,"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":"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":"percentage","negotiated_rate":20.0,"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":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 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":"percentage","negotiated_rate":20.0,"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":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.42,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1197.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.14,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":190.81,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.28,"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":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.01,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"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":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.99,"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":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.91,"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":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3850.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":144.88,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.84,"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":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.79,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2.36,"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":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7.25,"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":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.11,"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":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.04,"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":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":513.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.87,"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":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.32,"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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":149.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":126.49,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.04,"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":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":139.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":16.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and 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":[2]}]},{"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","zip":"10985","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":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.99,"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"]},{"negotiated_type":"negotiated","negotiated_rate":515.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"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":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.24,"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":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":168.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.89,"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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.1,"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":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.95,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.53,"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":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":58.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.72,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.34,"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":"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":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0433","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.96,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.39,"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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"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":"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.92,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2973.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"14001","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":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","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":[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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.0,"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":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.74,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1829.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":174.63,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.6,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.11,"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":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.06,"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.62,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.98,"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":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"10910","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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.43,"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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":148.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1034.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"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":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.67,"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":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.57,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":35.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.21,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.03,"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":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.2,"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":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"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":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.19,"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":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HQ"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.84,"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":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.17,"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"]},{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":50.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.1,"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":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"13143","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.38,"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":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":18.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.45,"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":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":120.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.02,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"percentage","negotiated_rate":20.0,"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":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.19,"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","zip":"14001","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":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":116.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.38,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac 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":"percentage","negotiated_rate":20.0,"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":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.75,"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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.75,"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":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":86.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":470.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.52,"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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":104.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.31,"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":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":126.61,"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":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.52,"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":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.79,"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":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.41,"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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin 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":"percentage","negotiated_rate":20.0,"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":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.52,"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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.52,"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":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.93,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.99,"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":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"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":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.64,"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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.95,"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":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":151.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.82,"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"]},{"negotiated_type":"negotiated","negotiated_rate":535.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":417.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.13,"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":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.71,"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":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.93,"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":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.29,"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":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.26,"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":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.71,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.74,"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":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1915.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.3,"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":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1854.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":310.25,"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":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.87,"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":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.01,"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":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.79,"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":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":189.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.39,"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":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":28.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3352.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.38,"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":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":8.13,"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":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.04,"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":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"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":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial 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":"percentage","negotiated_rate":20.0,"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":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":323.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":151.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":369.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"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":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.28,"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":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.24,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.1,"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"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":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.32,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.61,"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":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.52,"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":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["LR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1015.37,"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":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":25.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.65,"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"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.99,"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":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":83.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4084.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":76.63,"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":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":36.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":67.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":25.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1176.98,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2995.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0215","name":"Nonemerg transp mileage","description":"Non-emergency transportation; mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["LR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":111.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":143.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":385.25,"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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":57.97,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.23,"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":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.82,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.35,"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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KF"]},{"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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":575.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.4,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.27,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.4,"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":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.67,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":47.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HK"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.01,"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":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.75,"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":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.98,"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":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.2,"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":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.58,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.5,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.99,"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"]},{"negotiated_type":"negotiated","negotiated_rate":179.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.64,"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":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.1,"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":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.37,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.26,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.64,"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":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.05,"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":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.8,"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":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.02,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.94,"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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":225.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":70.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"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":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"10301","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":[7]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.38,"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":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.82,"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":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AX"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.16,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.84,"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":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10985","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":75.84,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.7,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.16,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2352.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.09,"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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":680.84,"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":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.88,"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":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4443.29,"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":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.8,"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":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.52,"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":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"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":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.19,"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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.49,"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":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":163.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.2,"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":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.08,"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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.42,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.27,"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":163.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":423.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":118.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":303.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"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":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"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":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.99,"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":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.73,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"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":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.66,"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":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.47,"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"]},{"negotiated_type":"negotiated","negotiated_rate":25.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10501","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":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.03,"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":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2374.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81296","name":"Msh2 gene known variants","description":"Msh2 (muts homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.66,"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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.19,"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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.82,"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":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.1,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3442.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1650.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HH"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.34,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.66,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.78,"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":"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":"percentage","negotiated_rate":20.0,"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":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2374.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":11.53,"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":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.25,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":358.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.84,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.97,"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":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.11,"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":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.02,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"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":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.97,"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":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.72,"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":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.26,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1116.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":51.7,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.57,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.8,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.57,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":124.59,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.35,"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"]}],"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":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","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":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"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":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":168.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.2,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.3,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.19,"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":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.19,"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":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"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":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.46,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.54,"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":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.31,"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":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.37,"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":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.42,"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":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.65,"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":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.13,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.17,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":91.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":117.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.05,"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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92921","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":16.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1516.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.03,"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":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":80.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.77,"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":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":71.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.97,"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":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.05,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","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":[2]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.55,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":35.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.34,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.81,"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":97.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.84,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.12,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.74,"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":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":121.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.94,"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":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81170","name":"Abl1 gene","description":"Abl1 (abl proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":12.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":356.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":200.65,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.02,"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.01,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":991.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","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":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.93,"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":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.43,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":118.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.47,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.8,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.42,"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":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["GT","U5","FQ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.59,"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":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.9,"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":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.99,"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"]},{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0426","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":71.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.86,"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":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.09,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":27.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":240.52,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.3,"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":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.35,"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":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.16,"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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.05,"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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.16,"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"]}],"provider_references":[2]}]},{"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":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.14,"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":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.3,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.06,"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":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.82,"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":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.46,"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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80145","name":"Drug assay adalimumab","description":"Adalimumab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"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":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":171.4,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2324.52,"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":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]},{"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"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":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.71,"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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.13,"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":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.99,"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":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.61,"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":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":414.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":14.84,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"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":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","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":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.12,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":62.8,"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":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":2377.31,"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":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":112.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.18,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6331.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.28,"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":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.41,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0431","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5067.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.57,"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":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.9,"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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.2,"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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.84,"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":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]},{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.8,"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":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81279","name":"Jak2 gene trgt sequence alys","description":"Jak2 (janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"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":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":109.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10985","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":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.36,"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":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":39.34,"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":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81206","name":"Bcr/abl1 gene major bp","description":"Bcr/abl1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"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":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.91,"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":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.08,"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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.38,"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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.92,"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":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4036","name":"Enteral feed sup kit grav by","description":"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.67,"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":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":52.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":686.08,"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":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":300.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.25,"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":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.23,"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":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0428","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.99,"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":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"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":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.35,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":369.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.5,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":75.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.55,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.23,"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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.46,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["CB"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1832.73,"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":"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":"13143","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":185.07,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.74,"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":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":44.63,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[4]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.62,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.26,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.58,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":113.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":175.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.03,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":402.63,"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"]},{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1710.71,"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":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.41,"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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2429.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.47,"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":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.24,"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":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":154.67,"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"]},{"negotiated_type":"negotiated","negotiated_rate":268.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":9.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1483.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":152.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":106.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81208","name":"Bcr/abl1 gene other bp","description":"Bcr/abl1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; other breakpoint, qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.35,"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":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.65,"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":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.58,"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":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"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":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":195.35,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.69,"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":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.57,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.26,"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":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.35,"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":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.11,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A0434","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.0,"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":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":115.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.51,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.56,"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":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":176.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"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":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.02,"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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.49,"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":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.9,"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":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.01,"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":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":205.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.63,"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":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.14,"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":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.31,"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":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.48,"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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":31.69,"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"]},{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.84,"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":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.36,"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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.03,"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":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":391.05,"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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"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":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":182.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.38,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.64,"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":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.38,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.66,"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":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1966.32,"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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.58,"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":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":65.32,"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":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6246.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.94,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","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":["QW"]}],"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","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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":365.09,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"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":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":249.43,"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":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.24,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":88.79,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":103.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.91,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80280","name":"Drug assay vedolizumab","description":"Vedolizumab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.14,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.71,"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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":646.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22533.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.78,"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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.32,"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":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":106.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.64,"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"]},{"negotiated_type":"negotiated","negotiated_rate":75.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":138.03,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.74,"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":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":357.93,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":287.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.38,"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":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"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"]},{"negotiated_type":"negotiated","negotiated_rate":199.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":150.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":82.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.94,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.97,"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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":42.82,"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"]},{"negotiated_type":"negotiated","negotiated_rate":66.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.55,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.3,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":991.66,"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":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"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":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.28,"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":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.12,"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4151.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.69,"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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.43,"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":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.25,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.41,"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":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.26,"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":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.15,"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":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.74,"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":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.14,"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"]},{"negotiated_type":"negotiated","negotiated_rate":154.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.26,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"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":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.38,"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":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","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":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":152.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10910","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.01,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.5,"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":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.5,"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":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"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":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.06,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":53.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.45,"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":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.42,"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":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.36,"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":"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":91.99,"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"]},{"negotiated_type":"negotiated","negotiated_rate":193.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.63,"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":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"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"]},{"negotiated_type":"negotiated","negotiated_rate":99.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":171.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":60.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.76,"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3124.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"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":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.56,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.95,"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":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.21,"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":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"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":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.88,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.72,"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":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"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":"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.43,"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":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.23,"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":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.77,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.82,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":40.17,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.16,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.46,"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":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":78.58,"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"]},{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":73.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.51,"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":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":26.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1838.25,"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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":18.24,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.76,"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":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.38,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.21,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":291.56,"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":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1959.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":63.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.23,"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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.02,"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":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1379.83,"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":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.19,"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":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0427","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.0,"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":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":14.04,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.79,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.43,"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"]},{"negotiated_type":"negotiated","negotiated_rate":240.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.68,"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":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.09,"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":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.8,"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":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.04,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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","KF"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"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":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.04,"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":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-06","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.75,"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":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.35,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":189.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.3,"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":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":185.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.49,"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":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2195.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"13020","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":[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":"14001","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":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.68,"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":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2948.5,"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":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.63,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.67,"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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":185.38,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":739.64,"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"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.74,"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":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K1005","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":219.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.79,"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":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.24,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.87,"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":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"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":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.42,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":56.63,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.94,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.6,"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":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.13,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic 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":"percentage","negotiated_rate":20.0,"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":"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.99,"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":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":282.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.52,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.72,"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":"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":"percentage","negotiated_rate":20.0,"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":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["U1"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.4,"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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.31,"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":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.51,"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"]},{"negotiated_type":"negotiated","negotiated_rate":446.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.57,"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":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5131.51,"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":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.56,"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":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77387","name":"Guidance for radj tx dlvr","description":"Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.15,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.76,"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":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.3,"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":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.66,"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":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.19,"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":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":213.54,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3142.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.48,"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":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.87,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7348.36,"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":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"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":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.14,"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":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.86,"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":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.77,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"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":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.6,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.86,"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":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":706.38,"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":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":61.98,"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":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"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":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.76,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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"],"billing_code_modifier":["TC"]}],"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"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":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"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":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"10047","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.09,"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":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.59,"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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":30.53,"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":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.09,"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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.58,"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":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.55,"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":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":145.5,"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.41,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.83,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.5,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.56,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":205.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.5,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":121.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":153.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.25,"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":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.3,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.17,"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":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81315","name":"Pml/raralpha com breakpoints","description":"Pml/raralpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.37,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.16,"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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":226.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.26,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.09,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":150.16,"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":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.71,"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":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2635.76,"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":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":128.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.99,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.83,"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":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.54,"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":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.26,"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":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.11,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.4,"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":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.42,"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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.89,"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":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.66,"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":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign 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":"percentage","negotiated_rate":20.0,"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":"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":"percentage","negotiated_rate":20.0,"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":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5105.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.04,"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":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":83.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.9,"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":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.87,"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":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":3080.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.55,"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":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":154.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2574.85,"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":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12331.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.62,"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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.3,"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":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.35,"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":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":84.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.29,"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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":44.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.36,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":181.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.14,"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":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1320201","zip":"10001","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":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical 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":"percentage","negotiated_rate":20.0,"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":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1854.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.99,"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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-06","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.02,"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":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":362.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.42,"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":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.75,"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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.46,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.65,"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":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":42.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.96,"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"]},{"negotiated_type":"negotiated","negotiated_rate":347.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81301","name":"Microsatellite instability","description":"Microsatellite instability analysis (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) of markers for mismatch repair deficiency (eg, bat25, bat26), includes comparison of neoplastic and normal tissue, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.91,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.94,"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":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.82,"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":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","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":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2005","name":"N-et; stretcher van","description":"Non-emergency transportation; stretcher van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TU"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.01,"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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["KF"]}],"provider_references":[4]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":67.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.45,"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":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.28,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":130.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.55,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.2,"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":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.03,"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":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.95,"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"]},{"negotiated_type":"negotiated","negotiated_rate":333.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":129.4,"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.07,"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":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":51.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":189.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.83,"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":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":3318.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.45,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":60.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.2,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2305.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":148.26,"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":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":103.04,"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":"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":"1320201","zip":"10001","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":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":5.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"14001","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":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.13,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.36,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.13,"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.45,"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":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.98,"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":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1399","name":"Durable medical equipment mi","description":"Durable medical equipment, miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U2"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":145.89,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"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":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.69,"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"]},{"negotiated_type":"negotiated","negotiated_rate":16.04,"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":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.17,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.12,"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":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.75,"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":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.11,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2251.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":131.01,"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"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.12,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.48,"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":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.01,"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":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.54,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":144.25,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HB"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.88,"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":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.21,"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":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.41,"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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":74.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.13,"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":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1264.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.56,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":76.37,"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":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":86.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.38,"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":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"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":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":114.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.39,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.32,"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":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":105.99,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.14,"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":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.28,"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":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.4,"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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.13,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.86,"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":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.87,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.76,"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.33,"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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"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":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":972.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.71,"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":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.15,"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":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.9,"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":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.29,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":28.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.82,"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"]},{"negotiated_type":"negotiated","negotiated_rate":169.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1320201","zip":"10001","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":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.17,"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":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-06","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.01,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.49,"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":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.65,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2886.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.39,"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":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2619.87,"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":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.91,"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":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.94,"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":"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.25,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.77,"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":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.1,"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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":165.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":92.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":141.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.55,"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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2032.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1052.19,"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":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","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":[2]}]},{"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":4.06,"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.72,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.95,"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":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.77,"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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.64,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":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"]},{"negotiated_type":"negotiated","negotiated_rate":62.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.74,"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":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.87,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":403.32,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.41,"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":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"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":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":156.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4179.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.09,"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":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5384.21,"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":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"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":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":155.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.85,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.1,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"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":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.2,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":51.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.91,"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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.76,"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":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"10047","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.88,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"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":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"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":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.46,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":22.34,"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":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81298","name":"Msh6 gene full seq","description":"Msh6 (muts homolog 6 [e. coli]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.3,"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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.63,"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":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.63,"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":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.21,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.76,"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":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.91,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.83,"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":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.25,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.35,"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"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":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.41,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2842.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.21,"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":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80325","name":"Amphetamines 3or 4","description":"Amphetamines; 3 or 4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1446.21,"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":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.3,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":79.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"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":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate 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":"percentage","negotiated_rate":20.0,"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":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.78,"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":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.34,"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":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.04,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.43,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.49,"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":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.42,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.34,"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":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.02,"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":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","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":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":262.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.93,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.63,"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":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.64,"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":"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80352","name":"Cannabinoid synthetic 7/more","description":"Cannabinoids, synthetic; 7 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.16,"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":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10910","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2912.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":474.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.55,"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":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.31,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.99,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":16.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5738.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":110.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.53,"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":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1750.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.46,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.73,"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":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.15,"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":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.2,"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":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.51,"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"]},{"negotiated_type":"negotiated","negotiated_rate":446.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.74,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":44.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.75,"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":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.15,"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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2345.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1301.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.32,"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":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.31,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"10910","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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1399","name":"Durable medical equipment mi","description":"Durable medical equipment, miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U1"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.3,"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":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.9,"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":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":53.55,"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":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"10047","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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.25,"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":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.97,"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":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":241.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.65,"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":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.43,"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":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.05,"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.73,"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":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":389.26,"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"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":175.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":226.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":58.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"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":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.84,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4341.9,"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":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.98,"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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.19,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":85.23,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.38,"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.74,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2602.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.21,"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":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":81.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":127.54,"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":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.21,"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":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2730.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.03,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"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":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.9,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.34,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1224.26,"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":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.97,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":126.45,"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":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.56,"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":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.14,"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":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.36,"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":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":127.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":105.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.02,"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":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.92,"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":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.77,"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":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"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":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":28.27,"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"]},{"negotiated_type":"negotiated","negotiated_rate":37.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.16,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.31,"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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.65,"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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.63,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1176.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.8,"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":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1274.45,"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":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.56,"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":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.13,"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":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.88,"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":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":74.73,"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"]},{"negotiated_type":"negotiated","negotiated_rate":25.21,"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":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.53,"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":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.68,"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":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.67,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":14.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":125.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.36,"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":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.04,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"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":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.83,"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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.34,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":106.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":124.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.3,"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":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.54,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.79,"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":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":211.95,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.54,"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":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":66.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1320201","zip":"10001","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":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.5,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.99,"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":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.39,"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":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"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":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.45,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.63,"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":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.13,"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":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.2,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.34,"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":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.86,"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":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.5,"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":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.25,"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":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.49,"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":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":174.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"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":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23073","name":"Exc shoulder tum deep 5 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"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":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.17,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.42,"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":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6191.1,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":202.67,"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":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.86,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"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":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.49,"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":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0426","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["SC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.81,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.27,"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":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":139.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.69,"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":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.27,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.34,"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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":100.59,"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"]},{"negotiated_type":"negotiated","negotiated_rate":50.86,"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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"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":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","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":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.42,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0215","name":"Nonemerg transp mileage","description":"Non-emergency transportation; mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"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":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":126.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":580.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GT","FQ","U3"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":239.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.9,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.71,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":47.53,"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":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.53,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening 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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.09,"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":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.46,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.59,"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":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":122.05,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":148.98,"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.05,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5337.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.31,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":134.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.4,"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":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.9,"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.58,"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":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6778.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.25,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":474.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"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":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.26,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.25,"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":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.78,"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":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.34,"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":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.61,"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"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":7.52,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"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":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.79,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"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":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":49.29,"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.42,"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":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"percentage","negotiated_rate":20.0,"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":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.34,"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":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.14,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.61,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.58,"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":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.58,"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":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"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":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"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"]},{"negotiated_type":"negotiated","negotiated_rate":635.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":102.78,"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"]}],"provider_references":[4]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.8,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.88,"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":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.39,"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":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.6,"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":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.38,"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":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.19,"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":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1264.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.58,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.05,"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":"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.97,"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":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.95,"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":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.55,"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":"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":"1328299","zip":"12007","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.89,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.07,"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":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":198.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.49,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.83,"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":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":57.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.66,"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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.99,"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":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.74,"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":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":123.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.12,"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":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.87,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.15,"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":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.93,"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":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":818.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"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":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.91,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.17,"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":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81294","name":"Mlh1 gene dup/delete variant","description":"Mlh1 (mutl homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.95,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.87,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.21,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.15,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.97,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":15.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.94,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":112.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.86,"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.45,"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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80358","name":"Drug screening methadone","description":"Methadone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.4,"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":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.26,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.93,"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":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.09,"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":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.96,"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"]},{"negotiated_type":"negotiated","negotiated_rate":126.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":710.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.2,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":331.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.87,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.1,"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":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.63,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":158.97,"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"]}],"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":"percentage","negotiated_rate":20.0,"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":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.43,"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":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.19,"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":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.26,"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":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.41,"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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1395.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"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":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.73,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"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":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.58,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.26,"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":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"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"]},{"negotiated_type":"negotiated","negotiated_rate":343.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.42,"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":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.48,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":33.34,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2114.56,"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":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.68,"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":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":38.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":113.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.89,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.74,"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":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.94,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.3,"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":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"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":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.77,"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":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.0,"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":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10910","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":14.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":54.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2619.87,"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":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10301","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":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.01,"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":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.55,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.74,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":70.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4480.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"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":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.05,"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":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.05,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.54,"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":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.63,"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":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.51,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.05,"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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.31,"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":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.02,"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":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80361","name":"Opiates 1 or more","description":"Opiates, 1 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.03,"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":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80354","name":"Drug screening fentanyl","description":"Fentanyl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.33,"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":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":477.66,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":85.99,"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"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.04,"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":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":395.37,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.41,"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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.61,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.15,"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":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.35,"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":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"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"]},{"negotiated_type":"negotiated","negotiated_rate":116.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.06,"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":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.61,"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":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.72,"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":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3093.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.95,"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":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.72,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"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":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.95,"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":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"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":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"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"]},{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":261.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.61,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.93,"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":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":30.25,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.02,"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":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.52,"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":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3597.02,"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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5251.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.85,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.1,"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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.84,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3551.46,"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":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control 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":"percentage","negotiated_rate":20.0,"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":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.02,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.52,"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":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.75,"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":153.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.17,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.38,"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"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":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.93,"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":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97153","name":"Adaptive behavior tx by tech","description":"Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.45,"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":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22900","name":"Exc abdl tum deep < 5 cm","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.86,"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":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.26,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.26,"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":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.56,"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":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.57,"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":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.39,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0209","name":"Wc van mileage per mi","description":"Wheelchair van, mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.84,"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":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.32,"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":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":171.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.69,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":44.59,"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"]},{"negotiated_type":"negotiated","negotiated_rate":77.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2101","name":"Breast milk proc/store/dist","description":"Human breast milk processing, storage and distribution only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.91,"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":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.31,"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":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.11,"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":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.76,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.41,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.35,"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":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":327.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.53,"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":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.97,"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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.51,"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":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.19,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.76,"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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.34,"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":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.02,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.74,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.01,"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":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.43,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.03,"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":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.36,"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":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.06,"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":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.77,"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":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.65,"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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":1009.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.53,"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":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.98,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.08,"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":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":377.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"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":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.17,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":222.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.94,"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":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.55,"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":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.55,"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":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.95,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":264.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.37,"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":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.49,"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":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation 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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.6,"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":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6407.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"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":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.11,"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":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0052A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.05,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.93,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.82,"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"]},{"negotiated_type":"negotiated","negotiated_rate":535.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.14,"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":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"13143","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.3,"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":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.95,"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":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.73,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.12,"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":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.19,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"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":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":474.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2567.38,"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":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted 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":"percentage","negotiated_rate":20.0,"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":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.77,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.31,"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":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":65.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":121.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.02,"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":"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":"percentage","negotiated_rate":20.0,"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":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":224.76,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3360.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.73,"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":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26","95"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.77,"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":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.24,"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":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","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":[2]}]},{"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":33.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.29,"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":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1320201","zip":"10001","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":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2730.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.14,"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":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.87,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"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":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"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":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10910","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.02,"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":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.5,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"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":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.52,"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":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.27,"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":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.75,"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.05,"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":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":405.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.41,"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"]},{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.79,"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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.17,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.11,"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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.27,"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":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.23,"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":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.71,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.16,"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":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.82,"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":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.21,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.08,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"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":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3807.53,"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":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.55,"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":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":365.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.91,"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":"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":"1329204","zip":"11004","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":[4]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":261.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":184.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.32,"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"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.26,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":159.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.6,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":414.65,"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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":150.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.52,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.1,"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":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.17,"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":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0215","name":"Nonemerg transp mileage","description":"Non-emergency transportation; mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TN"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.17,"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":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.42,"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":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":233.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":264.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10154.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.54,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.9,"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":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.05,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":102.61,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.02,"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"]},{"negotiated_type":"negotiated","negotiated_rate":398.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.97,"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":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":288.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.33,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":194.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.83,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2762.26,"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":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.69,"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":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.86,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.27,"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":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":74.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.41,"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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2531.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":121.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.53,"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":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":239.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1764.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3404.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":204.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.48,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":1446.97,"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":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":835.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.09,"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":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.35,"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":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":1019.86,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":235.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.09,"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":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"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":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.4,"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":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.98,"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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.26,"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":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-06","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.29,"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":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":186.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.79,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"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":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1607.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":268.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1349.9,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.72,"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":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.67,"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":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.13,"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":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1721.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":17.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":155.9,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":680.84,"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":"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1446.21,"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":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.29,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.58,"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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":109.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.77,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.8,"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":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.89,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","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":[2]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.16,"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":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81293","name":"Mlh1 gene known variants","description":"Mlh1 (mutl homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"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":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.01,"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":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.53,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.0,"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":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.94,"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":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":142.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":221.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.17,"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":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.66,"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":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.13,"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":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"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":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.03,"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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.91,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.31,"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":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":505.15,"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":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":146.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.97,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.05,"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":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.33,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.17,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.41,"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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.65,"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":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.3,"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":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":146.98,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"percentage","negotiated_rate":20.0,"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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.57,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.84,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.09,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.77,"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":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.12,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.56,"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":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.74,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"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"]},{"negotiated_type":"negotiated","negotiated_rate":89.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.51,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":694.11,"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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.25,"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":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"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":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.57,"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":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.84,"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":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.23,"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":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80171","name":"Drug screen quant gabapentin","description":"Gabapentin, whole blood, serum, or plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.17,"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":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"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":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.37,"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":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1408.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5012.28,"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":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.86,"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":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.77,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.09,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80350","name":"Cannabinoids synthetic 1-3","description":"Cannabinoids, synthetic; 1-3","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10047","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.12,"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":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.14,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.14,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.32,"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":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.95,"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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"10047","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.88,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.55,"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":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.36,"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":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81292","name":"Mlh1 gene full seq","description":"Mlh1 (mutl homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3734.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":118.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":179.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.74,"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":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.08,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":175.3,"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":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":1433.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":230.01,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"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":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.72,"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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.54,"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":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.32,"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":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":11.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.56,"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":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HB"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.31,"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":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":115.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.15,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.79,"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"]}],"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":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.69,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.34,"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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.55,"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"]},{"negotiated_type":"negotiated","negotiated_rate":125.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.68,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.65,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":227.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.55,"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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.58,"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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.06,"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":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.54,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.69,"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":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.01,"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":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"percentage","negotiated_rate":20.0,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"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":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"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":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.68,"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":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.72,"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["U2"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.41,"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":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.6,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"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":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.06,"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":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.42,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.72,"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":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.55,"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":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","zip":"10301","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"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, 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":"percentage","negotiated_rate":20.0,"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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.2,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["GT","FQ","U4"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":75.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.42,"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":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.86,"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":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2775.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.57,"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":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":83.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.71,"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.3,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.55,"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":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":975.34,"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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":178.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":689.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.29,"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":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.67,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.37,"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":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.68,"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":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":2942.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.11,"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":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.14,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"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":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.2,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.41,"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":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.05,"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":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":37.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.6,"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":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97158","name":"Grp adapt bhv tx by phy/qhp","description":"Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.74,"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":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.68,"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":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.02,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.93,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.19,"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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"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":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":481.82,"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":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":25.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.02,"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":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.93,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second 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":"percentage","negotiated_rate":20.0,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.09,"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":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3217","name":"Ladies shoes hightop depth i","description":"Orthopedic footwear, ladies shoe, hightop, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.56,"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":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.23,"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":"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":"percentage","negotiated_rate":20.0,"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":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.37,"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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.84,"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":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.91,"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":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"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":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.54,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","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":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.07,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.43,"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":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2555.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.43,"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":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional 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":"percentage","negotiated_rate":20.0,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":203.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.46,"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"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"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":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77425","name":"Io rad tx deliver by elctrns","description":"Intraoperative radiation treatment delivery, electrons, single treatment session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"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":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.74,"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":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.45,"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":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"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"]},{"negotiated_type":"negotiated","negotiated_rate":75.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.51,"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":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.57,"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":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.56,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.19,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.37,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.23,"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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.1,"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":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.43,"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":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.35,"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 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":"percentage","negotiated_rate":20.0,"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":"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":416.87,"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":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":19.18,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33928","name":"Rmvl & rplcmt tot hrt sys","description":"Removal and replacement of total replacement heart system (artificial heart)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.87,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.05,"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":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.1,"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":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.77,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.9,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3560.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.76,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":6.65,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.97,"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":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.84,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 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":"percentage","negotiated_rate":20.0,"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":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.45,"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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.48,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.16,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.65,"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":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.73,"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":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1195.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.36,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.26,"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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.5,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.49,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.1,"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":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":45.8,"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":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":273.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.76,"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":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"percentage","negotiated_rate":20.0,"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":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3099.78,"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":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.37,"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":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"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":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":143.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.66,"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":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.32,"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":61.98,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"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":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":3345.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":239.45,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":305.89,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.14,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":101.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":837.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.09,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","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":[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","locality":"1320201","zip":"10001","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":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":125.73,"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"]},{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.52,"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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.67,"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":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17380","name":"Electrolysis epilation ea 30","description":"Electrolysis epilation, each 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.37,"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":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.14,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.43,"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":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77387","name":"Guidance for radj tx dlvr","description":"Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.38,"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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.34,"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":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.98,"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":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.87,"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":"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.21,"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":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.87,"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":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.68,"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":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.06,"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":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":190.42,"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":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.36,"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":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"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":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.11,"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":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80326","name":"Amphetamines 5 or more","description":"Amphetamines; 5 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.64,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.05,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":843.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.16,"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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":126.49,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80161","name":"Asy carbamazepin 10,11-epxid","description":"Carbamazepine; -10,11-epoxide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.88,"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":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1320201","zip":"10001","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":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.38,"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":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.95,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.31,"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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.32,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.78,"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":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1559.66,"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":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.73,"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":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.77,"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":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0172A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.38,"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":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":170.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":348.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.35,"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":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.57,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.87,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.8,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":174.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":115.32,"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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.41,"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":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AX"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.35,"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":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1260.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"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":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.53,"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":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.6,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.46,"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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4502.39,"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":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.98,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":136.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":52.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.04,"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92944","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.63,"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":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":154.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.52,"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":"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"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":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.01,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1399","name":"Durable medical equipment mi","description":"Durable medical equipment, miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U3"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"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":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.61,"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":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.29,"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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81308","name":"Palb2 gene known famil vrnt","description":"Palb2 (partner and localizer of brca2) (eg, breast and pancreatic cancer) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.99,"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":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":253.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":358.78,"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":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.66,"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":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.49,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.89,"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":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.18,"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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.99,"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":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":153.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.67,"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":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.06,"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":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"13143","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":83.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.36,"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":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.31,"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":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3843.48,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":381.56,"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.54,"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":"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":"percentage","negotiated_rate":20.0,"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":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.98,"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":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1551.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.2,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":44.15,"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":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":107.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.25,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.15,"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":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.19,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same 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":"percentage","negotiated_rate":20.0,"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":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.93,"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"]},{"negotiated_type":"negotiated","negotiated_rate":208.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2005","name":"N-et; stretcher van","description":"Non-emergency transportation; stretcher van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HB"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":45.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.1,"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":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.09,"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":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":100.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":102.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.55,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.61,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.49,"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":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.94,"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":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.45,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9196.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.97,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":185.3,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":718.66,"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":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.81,"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"]},{"negotiated_type":"negotiated","negotiated_rate":69.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.21,"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"]},{"negotiated_type":"negotiated","negotiated_rate":246.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.69,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80199","name":"Drug screen quant tiagabine","description":"Tiagabine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.99,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","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":[2]}]},{"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":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.36,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.82,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.98,"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":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.08,"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":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.51,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.87,"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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.49,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3063.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"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":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.67,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":150.16,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.43,"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":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.98,"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":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":135.15,"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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.86,"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":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":381.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":144.25,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":204.87,"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":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.09,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.01,"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":"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":"1320201","zip":"10001","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":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":315.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.9,"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"]},{"negotiated_type":"negotiated","negotiated_rate":100.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":49.41,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5069.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.11,"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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":719.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.28,"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":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.31,"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":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1164.69,"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":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.13,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":150.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.3,"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":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.75,"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":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":16.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.67,"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":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":458.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":665.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.51,"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":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.19,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.24,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.03,"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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.13,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.29,"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":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.16,"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":51.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.12,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.2,"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":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.1,"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":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":239.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","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":[2]}]},{"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":139.9,"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"]},{"negotiated_type":"negotiated","negotiated_rate":242.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.24,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.93,"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":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":49.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.8,"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":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.45,"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":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.72,"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":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":358.78,"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":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.25,"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":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.77,"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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":159.91,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.38,"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.01,"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":58.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.38,"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":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.72,"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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.21,"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":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.53,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.13,"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":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","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":[2]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.43,"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"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81510","name":"Ftl cgen abnor three anal","description":"Fetal congenital abnormalities, biochemical assays of three analytes (afp, ue3, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.28,"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":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.96,"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":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.65,"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":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.68,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4914.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":97.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":30.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.64,"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":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81220","name":"Cftr gene com variants","description":"Cftr (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, acmg/acog guidelines)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":510.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.9,"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"]},{"negotiated_type":"negotiated","negotiated_rate":194.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.03,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":193.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":246.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":175.48,"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"]},{"negotiated_type":"negotiated","negotiated_rate":209.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.58,"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":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); 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":"percentage","negotiated_rate":20.0,"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":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.19,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96368","name":"Ther/diag concurrent inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, 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":[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","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.53,"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":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":189.6,"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":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.24,"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":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.78,"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":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":105.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.23,"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":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HK"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.94,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"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":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.11,"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":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":380.86,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":92.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.32,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.42,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4037.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1141.57,"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":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"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":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.5,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.55,"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":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.08,"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":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.97,"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":"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":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":187.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10012","name":"Fna bx w/mr gdn ea addl","description":"Fine needle aspiration biopsy, including mr 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.99,"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":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81338","name":"Mpl gene common variants","description":"Mpl (mpl proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, w515a, w515k, w515l, w515r)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":54.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.23,"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":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.95,"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":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-06","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.27,"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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":32.29,"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":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":137.57,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.74,"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":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":236.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.54,"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":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.34,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97157","name":"Mult fam adapt bhv tx gdn","description":"Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.21,"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":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.52,"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":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10501","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":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80363","name":"Opioids & opiate analogs 3/4","description":"Opioids and opiate analogs; 3 or 4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"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":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"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":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"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":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.12,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2589.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.95,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":18.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.59,"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":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":929.04,"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":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":188.43,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.3,"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":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","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":[2]}]},{"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","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":34.1,"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":"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":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.75,"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":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"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":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.76,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1419.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.36,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25071","name":"Exc forearm les sc 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.51,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.05,"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":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.69,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":248.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"13020","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.51,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.45,"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":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.93,"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":"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":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2217.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":235.59,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.0,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"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":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.98,"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":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.34,"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":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":445.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.84,"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":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU","AV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1612.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.27,"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":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.03,"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":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.67,"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":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.26,"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":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"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":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","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":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.6,"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":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"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":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":320.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":771.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80351","name":"Cannabinoids synthetic 4-6","description":"Cannabinoids, synthetic; 4-6","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.77,"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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.16,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.04,"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":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.78,"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":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.98,"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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80235","name":"Drug assay lacosamide","description":"Lacosamide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","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":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.79,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.4,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.94,"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":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3345.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.81,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.41,"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":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"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":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.9,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.78,"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":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.17,"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":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.22,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2997.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2906.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.03,"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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.0,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.82,"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":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2377.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1295.61,"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":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.95,"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":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.95,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.66,"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":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.16,"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":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.12,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.67,"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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.91,"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":236.1,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.57,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.03,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":1482.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2761.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":308.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.25,"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":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.66,"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":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.04,"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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.57,"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":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":20.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1531.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":107.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.42,"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":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26","95"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.33,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10910","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.66,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.56,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":128.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":129.58,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.75,"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":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.83,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"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":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.88,"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":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.91,"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":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":197.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.03,"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":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"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","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]},{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":69.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.49,"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":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.35,"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":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1692.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":58.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.27,"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":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":611.38,"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":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1915.56,"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":"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":40.3,"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":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.82,"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":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":122.34,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.75,"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":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.34,"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":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27632","name":"Exc leg/ankle les sc 3 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.4,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.52,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.09,"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":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.56,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.46,"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":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.62,"expiration_date":"9999-12-31","billing_class":"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","zip":"13143","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":[2]}]},{"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":"10047","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46748","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1744.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.28,"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":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":91.61,"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"]},{"negotiated_type":"negotiated","negotiated_rate":115.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.21,"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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.87,"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":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.84,"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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.33,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.26,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.41,"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":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"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":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.83,"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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"13143","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":["UE","NU","RR","KF"]}],"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":181.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":62.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81538","name":"Oncology lung","description":"Oncology (lung), mass spectrometric 8-protein signature, including amyloid a, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2871.0,"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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2320.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.51,"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":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.03,"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":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"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":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.37,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.53,"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"percentage","negotiated_rate":20.0,"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":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":177.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":327.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.6,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.04,"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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","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":["NU"]}],"provider_references":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.79,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.72,"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":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.67,"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":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.94,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":645.66,"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":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.25,"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":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.49,"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":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.35,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":28.27,"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.3,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":53.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.83,"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":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":57.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81352","name":"Tp53 gene trgt sequence alys","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.51,"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":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":235.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.86,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.79,"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":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.68,"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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.75,"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":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.15,"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":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":167.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":232.88,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.83,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80169","name":"Drug assay everolimus","description":"Everolimus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":500.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"13020","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":[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":"1329204","zip":"11004","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":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"S0209","name":"Wc van mileage per mi","description":"Wheelchair van, mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.74,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.23,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.41,"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":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.28,"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":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.23,"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":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":136.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.88,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.64,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":206.46,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"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":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.74,"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":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":74.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.97,"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":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"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":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.21,"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":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.83,"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":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"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":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0428","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.49,"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":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":298.5,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1399","name":"Durable medical equipment mi","description":"Durable medical equipment, miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["U5"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.5,"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":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2250.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86008","name":"Allg spec ige recomb ea","description":"Allergen specific ige; quantitative or semiquantitative, recombinant or purified component, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.55,"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":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.71,"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":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.63,"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":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":173.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.53,"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":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.53,"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":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.4,"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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.63,"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":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":105.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.83,"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":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.51,"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":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.88,"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":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4179.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.83,"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"]}],"provider_references":[2]}]},{"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","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.87,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.34,"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":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.93,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":771.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), 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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.99,"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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.71,"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":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.16,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":149.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","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":[2]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":377.88,"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":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.21,"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":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.5,"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":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.14,"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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2408.51,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.54,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97152","name":"Bhv id suprt assmt by 1 tech","description":"Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.25,"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":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.51,"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":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":127.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.63,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.42,"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"]},{"negotiated_type":"negotiated","negotiated_rate":5002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.11,"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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":411.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.45,"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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":138.31,"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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.66,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.9,"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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.21,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":158.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2811.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":85.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1270.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.46,"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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80163","name":"Assay of digoxin free","description":"Digoxin; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":4004.21,"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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3873.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.29,"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":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.3,"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":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.79,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.24,"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":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":242.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.03,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.93,"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":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":19.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.17,"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":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.05,"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":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.65,"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":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":150.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":246.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":131.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.95,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":228.41,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.95,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.12,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"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":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.8,"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.51,"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":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1650.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.02,"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":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2101.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":4004.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":689.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"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":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.61,"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":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.79,"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":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.72,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.98,"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":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, 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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.17,"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"]},{"negotiated_type":"negotiated","negotiated_rate":182.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":109.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.11,"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":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.67,"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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.76,"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":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","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":[2]}]},{"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":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":99.12,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.17,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.67,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.51,"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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3028.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. 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":"percentage","negotiated_rate":20.0,"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":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.53,"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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.84,"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":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87623","name":"Hpv low-risk types","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), low-risk types (eg, 6, 11, 42, 43, 44)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1446.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.89,"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":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.66,"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.1,"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":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":101.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"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":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.76,"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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.57,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.04,"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":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.06,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.84,"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":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.15,"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":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.0,"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":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.96,"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":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.23,"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":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.02,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2680.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.49,"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":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":219.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":150.4,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2023.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":61.08,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1116.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.45,"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":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.73,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","zip":"10501","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"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.25,"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":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3219.57,"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":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.48,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.31,"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.14,"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":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.26,"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":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.54,"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":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108243.35,"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":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"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":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.31,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":214.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.67,"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":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4915.21,"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":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81316","name":"Pml/raralpha 1 breakpoint","description":"Pml/raralpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.21,"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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.75,"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":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.99,"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":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.58,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.09,"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":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":66.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.82,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"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":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.46,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.37,"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":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.09,"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":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":221.71,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8510","name":"Scr dep neg, no plan reqd","description":"Screening for depression is documented as negative, a follow-up plan is not required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HD"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.47,"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":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.26,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.49,"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":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"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":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.27,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.16,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.98,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.67,"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":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.4,"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":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.63,"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":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.49,"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":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.1,"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":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":841.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1222.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.98,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.8,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.57,"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":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.15,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.31,"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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.43,"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":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.38,"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":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.01,"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":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.12,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.99,"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.48,"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"]},{"negotiated_type":"negotiated","negotiated_rate":56.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":209.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.12,"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":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.86,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.2,"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":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.58,"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":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.24,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.78,"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":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.68,"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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.17,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":175.45,"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.66,"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":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.26,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.93,"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8490","name":"100 insulin syringes","description":"Insulin syringes (100 syringes, any size)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":2578.02,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.72,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.09,"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":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.63,"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":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":42.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.79,"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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.11,"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":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4084.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":152.7,"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.51,"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":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.26,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.91,"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":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":171.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":177.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":347.75,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10071.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.87,"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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.63,"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":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.19,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"13020","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":[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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.29,"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":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.02,"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":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.15,"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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2703.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3597.02,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87506","name":"Iadna-dna/rna probe tq 6-11","description":"Infectious agent detection by nucleic acid (dna or rna); gastrointestinal pathogen (eg, clostridium difficile, e. coli, salmonella, shigella, norovirus, giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.99,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80337","name":"Tricyclic & cyclicals 6/more","description":"Antidepressants, tricyclic and other cyclicals; 6 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.32,"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":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.93,"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":"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":"13020","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic 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":"percentage","negotiated_rate":20.0,"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":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.89,"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":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.23,"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":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2333.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":167.54,"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.88,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":62.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.34,"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.08,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2402.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.49,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":150.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.23,"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":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.26,"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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.31,"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":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.41,"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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.23,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.34,"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":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"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":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.72,"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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.6,"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":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":1215.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"percentage","negotiated_rate":20.0,"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":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.99,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":467.13,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.32,"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":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":137.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.33,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":226.54,"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":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.14,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":64.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["TC"]}],"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","locality":"1320203","zip":"10512","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":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.28,"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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":186.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.98,"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":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":112.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":385.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.71,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.2,"expiration_date":"9999-12-31","billing_class":"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.49,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":397.54,"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":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"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":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":305.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":197.16,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.24,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.32,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.03,"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":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":79.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.81,"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":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.78,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":233.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":160.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.17,"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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.86,"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":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.45,"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":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.69,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.46,"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":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.65,"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":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":205.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.35,"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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61605","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.71,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1400.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.88,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.03,"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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.18,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0429","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"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":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.4,"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":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.01,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1009.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":134.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.21,"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":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.58,"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"]},{"negotiated_type":"negotiated","negotiated_rate":401.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.83,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex 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":"percentage","negotiated_rate":20.0,"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":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"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":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.66,"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":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.77,"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"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":201.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3118.68,"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":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.83,"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":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.08,"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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.31,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.21,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":57.6,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.42,"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"]},{"negotiated_type":"negotiated","negotiated_rate":151.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"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":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":294.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":218.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":169.66,"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":"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":72.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.58,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"13020","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.87,"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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.81,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":219.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.16,"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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.51,"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":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81363","name":"Hbb gene dup/del variants","description":"Hbb (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":61.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":104.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"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":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"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":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.27,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"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":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.94,"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":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":22.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.67,"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"]},{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.84,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2678.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.86,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.2,"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":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.3,"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":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.77,"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":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.24,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.24,"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81217","name":"Brca2 gene known famil vrnt","description":"Brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":1.73,"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"]},{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"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":"10301","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":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.13,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.23,"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":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":421.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.3,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":141.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.25,"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":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":200.33,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.99,"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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":105.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":173.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45499","name":"Laparoscope proc rectum","description":"Unlisted laparoscopy procedure, rectum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.06,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.15,"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":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81353","name":"Tp53 gene known famil vrnt","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"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":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.5,"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":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":50.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"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":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.71,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86794","name":"Zika virus igm antibody","description":"Antibody; zika virus, igm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10910","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":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.06,"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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.11,"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":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.93,"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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.32,"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":"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":"1320201","zip":"10001","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":["UE","NU","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.49,"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":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.56,"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":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2067.39,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic 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":"percentage","negotiated_rate":20.0,"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":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.1,"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":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"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":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.48,"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"]},{"negotiated_type":"negotiated","negotiated_rate":333.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.26,"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"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"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":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.8,"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":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.14,"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"]},{"negotiated_type":"negotiated","negotiated_rate":283.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"10910","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":[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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.44,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.38,"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":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.16,"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":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1204.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.42,"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"]},{"negotiated_type":"negotiated","negotiated_rate":85.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.41,"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":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":283.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":23.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3560.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.15,"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":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GT","U2","FQ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"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"]},{"negotiated_type":"negotiated","negotiated_rate":635.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"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":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.72,"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.4,"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":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":173.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":19.72,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.38,"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":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.39,"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":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":86.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.03,"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":"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":"percentage","negotiated_rate":20.0,"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":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3233.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.31,"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":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.27,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.73,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":19.04,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":130.11,"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":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"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":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.78,"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":"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":"percentage","negotiated_rate":20.0,"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":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.88,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":72.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.5,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":25.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.82,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.73,"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":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81248","name":"G6pd known familial variant","description":"G6pd (glucose-6-phosphate dehydrogenase) (eg, hemolytic anemia, jaundice), gene analysis; known familial variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.65,"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"]}],"provider_references":[4]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.94,"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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"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":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3782.6,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":293.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.25,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.23,"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":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":4107.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.43,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.31,"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":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8431","name":"Pos clin depres scrn f/u doc","description":"Screening for depression is documented as being positive and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HD"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.65,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.25,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.14,"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":"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":"1320201","zip":"10001","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":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.24,"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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.93,"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":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.86,"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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":198.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.37,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.58,"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":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":118.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.99,"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":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.3,"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":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":159.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":113.28,"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":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.13,"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":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","zip":"10301","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":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81278","name":"Igh@/bcl2 translocation alys","description":"Igh@/bcl2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (mbr) and minor cluster region (mcr) breakpoints, qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.25,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.77,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.21,"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":"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":"percentage","negotiated_rate":20.0,"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":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.67,"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":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":251.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":46.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.74,"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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic 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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.57,"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":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.41,"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":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":106.35,"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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":7.68,"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":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.49,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.69,"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":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":61.06,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.01,"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":78.74,"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":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.03,"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":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.67,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.03,"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":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":126.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.52,"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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.91,"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":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":315.25,"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":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":393.39,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.39,"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":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":178.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.46,"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":349.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.93,"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":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.45,"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":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.86,"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":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":1470.42,"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":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.13,"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":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.57,"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":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":64.89,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.38,"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":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.83,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.07,"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"]},{"negotiated_type":"negotiated","negotiated_rate":321.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.41,"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":"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.41,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1580.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.51,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.1,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.37,"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":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.47,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":40.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.75,"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":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.16,"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":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.1,"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":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening 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":"percentage","negotiated_rate":20.0,"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":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.57,"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":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.87,"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":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.94,"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":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.79,"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":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":45.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.98,"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":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":18.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.49,"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":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.38,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.57,"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":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":291.37,"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":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.79,"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":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":133.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.14,"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":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.16,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.89,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13143","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":[2]}]},{"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":62.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","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":[2]}]},{"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","zip":"10501","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"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.38,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.4,"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":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":14.87,"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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"10047","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.16,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.27,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":9.97,"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":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.14,"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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.16,"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":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"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":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); 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":"percentage","negotiated_rate":20.0,"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":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.11,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.35,"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":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.19,"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"14001","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":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"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":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":134.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1318.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.63,"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":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":3268.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":57.74,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.02,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.06,"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":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.52,"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":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.78,"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":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.57,"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":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"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":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"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":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2518.25,"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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":283.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":97.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.44,"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":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.47,"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":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2024.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1033.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.89,"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":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"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":"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":"1320203","zip":"10512","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":["NU"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.13,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.95,"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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.75,"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":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81161","name":"Dmd dup/delet analysis","description":"Dmd (dystrophin) (eg, duchenne/becker muscular dystrophy) deletion analysis, and duplication analysis, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.0,"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":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.08,"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":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.22,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"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":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"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":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), 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":"percentage","negotiated_rate":20.0,"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":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.45,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.78,"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":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.6,"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":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.98,"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":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":72.74,"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":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1527.13,"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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.41,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7.58,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"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":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10047","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.97,"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":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.15,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.19,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.96,"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":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.99,"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":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5843.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.75,"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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.99,"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":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.11,"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":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.74,"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":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.53,"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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.85,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":83.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":145.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.72,"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":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.65,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":263.22,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2997.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3099.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"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":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1208.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.46,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.12,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.19,"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":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.83,"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":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.53,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.57,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":18.4,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.66,"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":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.75,"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":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.21,"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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.77,"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":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.38,"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":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.12,"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":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.76,"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":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.28,"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":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.64,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.11,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.75,"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":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.27,"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":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.61,"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":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex 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":"percentage","negotiated_rate":20.0,"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":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"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":125.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.8,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":89.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.19,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.73,"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":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.96,"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"]},{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.04,"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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.57,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.89,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.74,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.91,"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":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":5119.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":416.39,"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.01,"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"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.2,"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":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with 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":"percentage","negotiated_rate":20.0,"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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.24,"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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97156","name":"Fam adapt bhv tx gdn phy/qhp","description":"Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"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":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.41,"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":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.78,"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":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":114.05,"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"]},{"negotiated_type":"negotiated","negotiated_rate":186.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.41,"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":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"13143","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.11,"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":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13143","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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25078","name":"Resect forarm/wrist tum 3cm>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.66,"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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":4.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":104.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.19,"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":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.93,"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":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","KC","MS"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.13,"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.93,"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"]},{"negotiated_type":"negotiated","negotiated_rate":84.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":17.3,"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":9.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.21,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":163.13,"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":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.98,"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":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81300","name":"Msh6 gene dup/delete variant","description":"Msh6 (muts homolog 6 [e. coli]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"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":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.34,"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":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77424","name":"Io rad tx delivery by x-ray","description":"Intraoperative radiation treatment delivery, x-ray, single treatment session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.97,"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":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.82,"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":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"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":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.25,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":123.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":51.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.27,"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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":842.65,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.88,"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":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.79,"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":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.73,"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.84,"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":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.01,"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":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13020","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HI"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81168","name":"Ccnd1/igh translocation alys","description":"Ccnd1/igh (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"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":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.56,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.13,"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":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.14,"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":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.4,"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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.49,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":14.04,"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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3843.48,"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":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.79,"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":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.67,"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"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.2,"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":145.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"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":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":431.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.26,"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":"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.09,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"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":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":53.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":79.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.52,"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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":210.48,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":437.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.8,"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":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.62,"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":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":108.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"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":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.87,"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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.41,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":72.14,"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":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.87,"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":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.59,"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"]},{"negotiated_type":"negotiated","negotiated_rate":112.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":39.68,"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"]}],"provider_references":[2]}]},{"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":153.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":135.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.99,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.29,"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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":53.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":182.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.31,"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.29,"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80167","name":"Drug assay felbamate","description":"Felbamate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":97.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.42,"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":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.6,"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":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1483.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2791.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.32,"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":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1519.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TJ"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1794.02,"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":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.81,"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"]},{"negotiated_type":"negotiated","negotiated_rate":442.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.87,"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":"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":"percentage","negotiated_rate":20.0,"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":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.78,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.31,"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":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.3,"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":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.12,"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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.08,"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":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.38,"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":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1108.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":182.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.87,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"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":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":157.11,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"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":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"10501","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":[6]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":235.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial 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":"percentage","negotiated_rate":20.0,"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":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"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":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"10985","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.77,"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":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.07,"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"]}],"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":90.64,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":144.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2066.4,"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":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2420.51,"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":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":150.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"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":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.78,"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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":167.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.31,"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":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.54,"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":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":210.97,"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":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.37,"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":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.07,"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":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":164.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":105.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","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":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":99.96,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.67,"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":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.71,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":353.5,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.47,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":142.25,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.41,"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":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.19,"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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2684.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.7,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.61,"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":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.84,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.9,"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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2.19,"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":"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.9,"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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":47.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":117.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TN"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":223.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":50.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":52.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":97.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":191.03,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":312.67,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1195.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.36,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":266.31,"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":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":167.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.84,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2678.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.55,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1239.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":75.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1013","name":"Sign lang/oral interpreter","description":"Sign language or oral interpretive services, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"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":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.01,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.54,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2223.19,"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":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"13143","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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0435","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.87,"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":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.49,"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":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.63,"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":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":267.39,"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":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":58.6,"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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.26,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3080.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":219.75,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.55,"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":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.46,"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":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"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":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":120.05,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear 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":"percentage","negotiated_rate":20.0,"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":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.25,"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":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.29,"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":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.6,"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":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.77,"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":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.32,"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":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.41,"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":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.53,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.91,"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":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.14,"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":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.73,"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":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2756.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.15,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":158.97,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":2742.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.9,"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":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.83,"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":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.82,"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":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":100.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1585.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[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","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.67,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.08,"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":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.56,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.83,"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":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.08,"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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.6,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"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":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"14001","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":[5]}]},{"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","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"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":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.52,"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":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":92.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.45,"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":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.33,"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":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.19,"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":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":127.02,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"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":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":118.96,"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"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"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"]},{"negotiated_type":"negotiated","negotiated_rate":66.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":191.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":195.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1172.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":321.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93271","name":"Ecg/monitoring and analysis","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":313.26,"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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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":["UE","NU","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.08,"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":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","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":[2]}]},{"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":448.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.14,"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"]},{"negotiated_type":"negotiated","negotiated_rate":154.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":217.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":162.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.32,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":115.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1915.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1039.8,"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":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.87,"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":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1339.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.66,"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":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.1,"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":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.94,"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":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.09,"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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"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":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.21,"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":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":158.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.64,"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":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.47,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":101.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.26,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":348.49,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":166.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.65,"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":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":306.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"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":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.43,"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":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.52,"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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.95,"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":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.08,"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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.43,"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":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.82,"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":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.27,"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":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95984","name":"Alys brn npgt prgrmg addl 15","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":2747.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.02,"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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.1,"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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.28,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.41,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.51,"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":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":38.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.44,"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":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":147.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.42,"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":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.13,"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":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.06,"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":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.69,"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":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.83,"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":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.09,"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":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":132.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, 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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.39,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1829.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2742.8,"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":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.13,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50432","name":"Plmt nephrostomy catheter","description":"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.89,"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":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.36,"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":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.57,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.78,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.42,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.06,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.27,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1320201","zip":"10001","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":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"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":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":316.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TK"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"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":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":52.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic 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":"percentage","negotiated_rate":20.0,"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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.53,"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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.25,"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":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.73,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.01,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.81,"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":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"13143","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.37,"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.58,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"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":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.35,"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":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.04,"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":"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":44.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.65,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.66,"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":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.58,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.69,"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"]}],"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.34,"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":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.5,"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":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.81,"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":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.08,"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":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80175","name":"Drug screen quan lamotrigine","description":"Lamotrigine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.04,"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":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":180.82,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"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":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.35,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":147.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.87,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.04,"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":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.59,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"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"]},{"negotiated_type":"negotiated","negotiated_rate":100.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.03,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10910","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81360","name":"Zrsr2 gene common variants","description":"Zrsr2 (zinc finger ccch-type, rna binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, e65fs, e122fs, r448fs)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"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":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.73,"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":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.1,"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":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.89,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":167.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial 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":"percentage","negotiated_rate":20.0,"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":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.97,"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":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.09,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.36,"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":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81258","name":"Hba1/hba2 gene fam vrnt","description":"Hba1/hba2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, hb bart hydrops fetalis syndrome, hbh disease), gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":589.16,"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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":201.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":151.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":209.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":5078.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.95,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.28,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.26,"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":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.78,"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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.69,"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":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"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":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0899","name":"Pow mobil dev no dmepdac","description":"Power mobility device, not coded by dme pdac or does not meet criteria","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.8,"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":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-06","zip":"10985","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":144.14,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10301","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":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":73.08,"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":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81348","name":"Srsf2 gene common variants","description":"Srsf2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, p95h, p95l)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":8.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.32,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":98.98,"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":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.56,"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":"D7252","name":"Part extract for implant","description":"Part extract for implant","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["HA"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.25,"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":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.89,"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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.52,"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":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.02,"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"]},{"negotiated_type":"negotiated","negotiated_rate":110.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.85,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.05,"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":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.63,"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":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.27,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.17,"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":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.93,"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":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2004","name":"N-et; commerc carrier pass","description":"Non-emergency transport; commercial carrier, multi-pass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TN"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same 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":"percentage","negotiated_rate":20.0,"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":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":320.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":38.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81245","name":"Flt3 gene","description":"Flt3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; internal tandem duplication (itd) variants (ie, exons 14, 15)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":242.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":139.9,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":338.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1399","name":"Durable medical equipment mi","description":"Durable medical equipment, miscellaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U4"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.41,"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":"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":35.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":1874.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":181.58,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"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"]},{"negotiated_type":"negotiated","negotiated_rate":116.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.46,"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.67,"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":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.91,"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":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":132.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.98,"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":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2138.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":158.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0428","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.14,"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":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.41,"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":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","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":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.68,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.58,"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":"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":158.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2811.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"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":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.51,"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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.66,"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":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":72.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.61,"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":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.27,"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":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.95,"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"]},{"negotiated_type":"negotiated","negotiated_rate":82.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":81.93,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.93,"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":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.83,"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"]}],"provider_references":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.46,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.23,"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":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U3"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.45,"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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":1262.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.37,"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":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.77,"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":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.82,"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":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.1,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.39,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, 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":"percentage","negotiated_rate":20.0,"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":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.11,"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":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.25,"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":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.51,"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":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":31.38,"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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.53,"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":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.68,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":402.63,"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"]},{"negotiated_type":"negotiated","negotiated_rate":222.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.02,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.22,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.91,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80203","name":"Drug screen quant zonisamide","description":"Zonisamide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":98.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":2908.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":233.89,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":268.32,"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":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":167.54,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.11,"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":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4676.12,"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":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.8,"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":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation 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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":148.89,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"81215","name":"Brca1 gene known famil vrnt","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":166.84,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.07,"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"]},{"negotiated_type":"negotiated","negotiated_rate":321.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"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":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.87,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.79,"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":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.67,"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":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"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":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.28,"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":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"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":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.34,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"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":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"percentage","negotiated_rate":20.0,"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":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9900","name":"Supply/accessory/service","description":"Miscellaneous dme supply, accessory, and/or service component of another hcpcs code","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2339.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"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":124.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.17,"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":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.79,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":715.18,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":131.41,"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":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.72,"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":"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":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.45,"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":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.72,"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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":126.25,"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"]}],"provider_references":[4]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"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":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"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":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"10910","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7679.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.8,"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":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.35,"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":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":170.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":100.59,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":117.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.38,"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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.09,"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.95,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"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":"37227","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.49,"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":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.45,"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":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.58,"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":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.41,"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":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.65,"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":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.03,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":39.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":57.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.02,"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":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":19.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1909.75,"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":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"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"]},{"negotiated_type":"negotiated","negotiated_rate":149.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.75,"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":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"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":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1865.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.05,"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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.8,"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":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.69,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.86,"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":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.14,"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":"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":181.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":329.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.05,"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":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":44.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.42,"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":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.68,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.72,"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":"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.16,"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":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":964.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.85,"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":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.64,"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":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.76,"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":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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":"1320201","zip":"10001","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":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.77,"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":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":73.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.57,"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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with 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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.97,"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":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.85,"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"]},{"negotiated_type":"negotiated","negotiated_rate":385.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.17,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":348.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":46.93,"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":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.98,"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":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":55.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"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":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":510.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0050","name":"Alcohol/drug service 15 min","description":"Alcohol and/or drug services, brief intervention, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.01,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.72,"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":"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":53.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.72,"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":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.02,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.13,"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":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.25,"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":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","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":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2777.56,"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":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"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":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.74,"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":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.64,"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":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.43,"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":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.77,"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":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":255.23,"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":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.95,"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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.67,"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":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.08,"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":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4094.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.36,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"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":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.67,"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":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.72,"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":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"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":"1328299","zip":"12007","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":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.01,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2022","name":"Case management, per month","description":"Case management, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":192.74,"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":1260.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.89,"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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"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":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","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":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0209","name":"Wc van mileage per mi","description":"Wheelchair van, mileage, per mile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":719.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":115.03,"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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 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":"percentage","negotiated_rate":20.0,"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":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80180","name":"Drug scrn quan mycophenolate","description":"Mycophenolate (mycophenolic acid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.05,"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":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","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":["QW"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.02,"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":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.52,"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":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"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":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.68,"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"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":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.16,"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":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.03,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":35.05,"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":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.72,"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":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.65,"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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":84.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.04,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.92,"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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":141.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.74,"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":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.2,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.75,"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":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.17,"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":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.75,"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":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"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":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":79.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":84.11,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.84,"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":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.11,"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":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"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":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.73,"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":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.84,"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":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.86,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.01,"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":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.83,"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":"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":"percentage","negotiated_rate":20.0,"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":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.84,"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":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.28,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":13.89,"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":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.84,"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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.01,"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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, 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":"percentage","negotiated_rate":20.0,"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":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1176.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.41,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.32,"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":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":97.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.73,"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":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.05,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4264","name":"Intratubal occlusion device","description":"Permanent implantable contraceptive intratubal occlusion device(s) and delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.0,"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":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":127.02,"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":84.46,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.71,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9593.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.08,"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":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.02,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0426","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.41,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"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":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.3,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":275.11,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":83.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.43,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.29,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.63,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.98,"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","zip":"13143","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":82.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.55,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.92,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"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":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":74.04,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"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":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.97,"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":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.22,"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"]},{"negotiated_type":"negotiated","negotiated_rate":421.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"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":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.41,"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":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":45.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.17,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.61,"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":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.8,"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":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20916.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.71,"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":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.53,"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":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":102.95,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.15,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.03,"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U4"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.24,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.16,"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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":83.73,"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":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), 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":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.02,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.89,"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":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.39,"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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":154.67,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.77,"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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4187","name":"Omegaven, 10 grams lipids","description":"Omegaven, 10 grams lipids","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":75.03,"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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":114.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2886.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.41,"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":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.01,"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":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":179.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"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":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","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":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":85.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81362","name":"Hbb gene known fam variant","description":"Hbb (hemoglobin, subunit beta) (eg, sickle cell anemia, beta thalassemia, hemoglobinopathy); known familial variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.84,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":235.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.13,"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":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.78,"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":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.42,"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":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":105.99,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.78,"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":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1828.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.15,"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"]},{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.96,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.94,"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":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.44,"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":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.73,"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":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.76,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.41,"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":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.6,"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":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"10047","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.46,"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":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.82,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.28,"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":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":81.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.71,"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":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.18,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":23.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.54,"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":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.01,"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"]}],"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.5,"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":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.6,"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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.38,"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":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.21,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"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":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.04,"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":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE","TN"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13143","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":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":127.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.25,"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":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":18.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":224.76,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.09,"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":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":137.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.06,"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":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.83,"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":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92929","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.56,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.95,"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":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.76,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4471.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.71,"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":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["LM"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.06,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":783.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.88,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"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":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":181.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":39.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":107.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9734.99,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.33,"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":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[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":"1320201","zip":"10001","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":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.08,"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":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.58,"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":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80159","name":"Drug assay clozapine","description":"Clozapine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":615.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.38,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":1141.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":148.77,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.27,"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":"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":"13143","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":81.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":31.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.45,"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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.17,"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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":334.52,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.79,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.54,"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"]},{"negotiated_type":"negotiated","negotiated_rate":175.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.1,"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":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.63,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.5,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":347.57,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial 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":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.18,"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":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.09,"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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":119.12,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":191.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.95,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.8,"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":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.75,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33929","name":"Rmvl rplcmt hrt sys f/trnspl","description":"Removal of a total replacement heart system (artificial heart) for heart transplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.95,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.51,"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":"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":"percentage","negotiated_rate":20.0,"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":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.34,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2567.38,"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":"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":73.13,"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"]},{"negotiated_type":"negotiated","negotiated_rate":85.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"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":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.39,"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":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1144.12,"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":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81295","name":"Msh2 gene full seq","description":"Msh2 (muts homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.03,"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":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":197.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.33,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.57,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":33.29,"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":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":183.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.84,"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":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TK"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":90.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4717.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.55,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":1492.72,"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":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.21,"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":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":241.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.83,"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":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","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"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.6,"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":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.71,"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":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","zip":"10910","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":["NU"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.57,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"13143","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.97,"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":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.41,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.97,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":2994.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49465","name":"Fluoro exam of g/colon tube","description":"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":127.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.09,"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":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.78,"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":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.0,"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":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"13020","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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.88,"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":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.43,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.46,"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":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.43,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.54,"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":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.23,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"13143","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.69,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.98,"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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.34,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.6,"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":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.4,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":0.21,"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":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":55.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.89,"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":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2313.67,"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":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.58,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.9,"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":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.41,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.29,"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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1606.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":508.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.09,"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":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.13,"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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":437.64,"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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1208.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.61,"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":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.57,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":195.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":96.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.78,"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":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.58,"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":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.93,"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":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.0,"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":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.58,"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"]},{"negotiated_type":"negotiated","negotiated_rate":78.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.87,"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":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.74,"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":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.81,"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":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.19,"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":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.68,"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":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":67.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.87,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":183.2,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.57,"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":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.08,"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":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.14,"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":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.37,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10501","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":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.53,"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":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.32,"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":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":101.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1794.02,"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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.24,"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":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2928.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10985","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":["NU"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10910","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.91,"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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":21.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.24,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":101.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"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":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.23,"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":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","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":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","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":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.73,"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":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":331.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.24,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.72,"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":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.76,"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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.08,"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"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":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":423.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":163.52,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.98,"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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":109.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2762.26,"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":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"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":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.45,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.4,"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":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"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":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.63,"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":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"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":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1772.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.5,"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":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":3404.73,"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":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1336.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":104.02,"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":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.74,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":109.14,"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"]},{"negotiated_type":"negotiated","negotiated_rate":147.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.88,"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"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":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.67,"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":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"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":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.76,"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":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.5,"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":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":101.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":39.53,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason 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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":306.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.82,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.93,"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"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":"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1247.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area 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":"percentage","negotiated_rate":20.0,"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":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":111.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.43,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.59,"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":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.06,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.37,"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":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":453.49,"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":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TK"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.79,"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":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.95,"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":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"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":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":31.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3385.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"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":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":133.76,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":194.47,"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"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"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":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.86,"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.51,"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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":904.89,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":39.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.29,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"10910","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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":38.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","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":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.46,"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"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.97,"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":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.08,"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"]},{"negotiated_type":"negotiated","negotiated_rate":86.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"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":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.2,"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":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":586.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.53,"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":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.51,"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":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":113.7,"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"]},{"negotiated_type":"negotiated","negotiated_rate":175.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.95,"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":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":40.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.11,"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":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":75.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.49,"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":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.64,"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"]},{"negotiated_type":"negotiated","negotiated_rate":190.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"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":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.38,"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":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.77,"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":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.88,"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":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.17,"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":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.86,"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":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.21,"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":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.64,"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":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"10301","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":[7]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81192","name":"Ntrk2 translocation analysis","description":"Ntrk2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.26,"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":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.14,"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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.85,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.88,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":19.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":149.36,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.45,"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":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":53.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":79.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.26,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1692.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.04,"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":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.27,"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":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.13,"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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12767.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":246.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TG"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.63,"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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.84,"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":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.06,"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":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.76,"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":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":347.57,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":120.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":20.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.93,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.1,"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":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":60.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.6,"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":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":4.09,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.65,"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":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TJ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.41,"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":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":310.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.83,"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":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":67.05,"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":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.89,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.94,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.15,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.63,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":156.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":30.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.43,"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":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.23,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":559.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.57,"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":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":81.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":121.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.65,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.26,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1931.29,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.33,"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":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.83,"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":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":200.33,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":186.32,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.71,"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":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3654.29,"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":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.03,"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.27,"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":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.64,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.09,"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":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.63,"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":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.65,"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":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.72,"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":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":70.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":165.2,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.77,"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":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.61,"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":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1146.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.46,"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"]},{"negotiated_type":"negotiated","negotiated_rate":209.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.79,"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":"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.46,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":41.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":75.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"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":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1216.8,"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":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.75,"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":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care 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":"percentage","negotiated_rate":20.0,"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":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.98,"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":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.04,"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":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":118.96,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":946.74,"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":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.99,"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":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14621.82,"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":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.35,"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":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.67,"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":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.88,"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":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.53,"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":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","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":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":159.29,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":42.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.91,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.87,"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":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.41,"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":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.32,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["GT","HE","FQ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":333.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1222.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":582.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":9.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.87,"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":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.31,"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":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":20.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.52,"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":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1500.24,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":24.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"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":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.0,"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":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.92,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10047","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.5,"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"]},{"negotiated_type":"negotiated","negotiated_rate":377.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80349","name":"Cannabinoids natural","description":"Cannabinoids, natural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":76.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"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":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3806.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2017.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"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":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81194","name":"Ntrk translocation analysis","description":"Ntrk (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.72,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4189","name":"Parenteral sol amino acid &","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.06,"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":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":174.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4172","name":"Parenteral sol amino acid 5.","description":"Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GT","FQ","U1"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.24,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2251.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":131.01,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.58,"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":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":1395.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.08,"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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":77.39,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","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":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","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":[2]}]},{"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":191.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":429.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.54,"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":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.69,"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":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"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":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.4,"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":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"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":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1108.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.0,"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":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80324","name":"Drug screen amphetamines 1/2","description":"Amphetamines; 1 or 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":163.99,"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"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.21,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.35,"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":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"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":"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"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":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":39.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.54,"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":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.42,"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"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":943.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.1,"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":"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":"1320201","zip":"10001","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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99051","name":"Med serv eve/wkend/holiday","description":"Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"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":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":112.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":178.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81512","name":"Ftl cgen abnor five anal","description":"Fetal congenital abnormalities, biochemical assays of five analytes (afp, ue3, total hcg, hyperglycosylated hcg, dia) utilizing maternal serum, algorithm reported as a risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.52,"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":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.11,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.3,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.06,"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":36.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":67.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.57,"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":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.26,"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":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.31,"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":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.28,"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":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.54,"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":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.54,"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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"percentage","negotiated_rate":20.0,"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":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.69,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.37,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.02,"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":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":172.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":148.98,"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"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.88,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.99,"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"]},{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.09,"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":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.24,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.23,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":298.4,"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":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":649.11,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3385.83,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.28,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3794.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.32,"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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.98,"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":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.76,"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.79,"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":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.23,"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":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.31,"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":"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","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":[2]}]},{"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":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"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":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.56,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.27,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.08,"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":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.46,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92925","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.38,"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":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.67,"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":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.24,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":787.04,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"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":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":244.17,"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.65,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.2,"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":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.38,"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":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.11,"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":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.71,"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.89,"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":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.11,"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"]},{"negotiated_type":"negotiated","negotiated_rate":155.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.21,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":73.38,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.63,"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":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":67.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.45,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.35,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.82,"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":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"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":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.73,"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":"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":"percentage","negotiated_rate":20.0,"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":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.28,"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":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.91,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.32,"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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.65,"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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.09,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.84,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.86,"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":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":118.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.77,"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":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.47,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.37,"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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1165.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.12,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.51,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4383.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":25.72,"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":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.25,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.93,"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":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.28,"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":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.39,"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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.98,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":1204.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.76,"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"]},{"negotiated_type":"negotiated","negotiated_rate":200.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80204","name":"Drug assay methotrexate","description":"Methotrexate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.69,"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":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.66,"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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33258","name":"Ablate atria x10sv add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.68,"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.67,"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":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.16,"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":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.34,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.25,"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":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.86,"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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"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":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.88,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.78,"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":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.94,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.61,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.36,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.66,"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":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.53,"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":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.58,"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":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"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":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.38,"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"]},{"negotiated_type":"negotiated","negotiated_rate":268.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.08,"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":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1270.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.57,"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":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.03,"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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":178.84,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.86,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.31,"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":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.24,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.17,"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":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"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":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81511","name":"Ftl cgen abnor four anal","description":"Fetal congenital abnormalities, biochemical assays of four analytes (afp, ue3, hcg [any form], dia) utilizing maternal serum, algorithm reported as a risk score (may include additional results from previous biochemical testing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.5,"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":84.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.88,"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":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.32,"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":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.46,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.49,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.58,"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"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":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":22.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.35,"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":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":41.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.65,"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":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.09,"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"]},{"negotiated_type":"negotiated","negotiated_rate":254.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.1,"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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.51,"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":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.02,"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":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":405.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.46,"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":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.54,"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":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":124.06,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.28,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"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":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.23,"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":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.58,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":172.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":327.65,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.42,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":414.65,"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":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.02,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.35,"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":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.09,"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":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.38,"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":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.17,"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":"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":"13020","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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81299","name":"Msh6 gene known variants","description":"Msh6 (muts homolog 6 [e. coli]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"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":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.16,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.27,"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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HB"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.57,"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":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.01,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.74,"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":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10047","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.75,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":19.15,"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":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.73,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.87,"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":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.43,"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":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.8,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.58,"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":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.21,"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":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.67,"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":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.56,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10301","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"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.72,"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":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":174.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":251.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":124.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.24,"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":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","zip":"13020","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":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.71,"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":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":424.53,"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":"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":"1320201","zip":"10001","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":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":191.73,"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":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.11,"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":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13020","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.91,"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":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.79,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"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":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"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":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.31,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.89,"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":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.84,"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":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.38,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.83,"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"]},{"negotiated_type":"negotiated","negotiated_rate":75.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.69,"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":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.16,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.4,"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":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.0,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.21,"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":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.21,"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":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.46,"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":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.49,"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":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.64,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":73.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":114.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.85,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":10.02,"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":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"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"]},{"negotiated_type":"negotiated","negotiated_rate":331.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.76,"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":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.73,"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":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.17,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":19.18,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.69,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.59,"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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.57,"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":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.87,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":150.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.93,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.79,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"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":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.71,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.66,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"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":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.6,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.79,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.61,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"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":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":31.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["U2"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":11.54,"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"]},{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.49,"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":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"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":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":25.69,"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":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2035.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.04,"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":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.42,"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":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.75,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.1,"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1262.68,"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":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":878.06,"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":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d 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, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.54,"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":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.49,"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"]},{"negotiated_type":"negotiated","negotiated_rate":161.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.4,"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"]},{"negotiated_type":"negotiated","negotiated_rate":150.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.6,"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":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.44,"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":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.14,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":94.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.66,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.46,"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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.28,"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":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.17,"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":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1340.16,"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":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.95,"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":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":8.19,"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":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":125.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.87,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.8,"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":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":9.71,"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"]},{"negotiated_type":"negotiated","negotiated_rate":18.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.68,"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"]}],"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":"1320201","zip":"10001","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":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.3,"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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"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":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.26,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.55,"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":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.0,"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":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":94.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.28,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.13,"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":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.97,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.1,"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":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.02,"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"]},{"negotiated_type":"negotiated","negotiated_rate":398.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.66,"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.57,"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"]},{"negotiated_type":"negotiated","negotiated_rate":469.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.76,"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":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.91,"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":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.93,"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":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5078.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":402.87,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.79,"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":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":15.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.61,"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":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","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":[2]}]},{"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","zip":"10985","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":800.42,"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":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.69,"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":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.69,"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":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.17,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.52,"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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.97,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.8,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"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":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.84,"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.44,"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"]},{"negotiated_type":"negotiated","negotiated_rate":107.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and 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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.26,"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":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.73,"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":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.67,"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":"98986","name":"Rtm dev sply cbt 2-15 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 cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.51,"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"]},{"negotiated_type":"negotiated","negotiated_rate":205.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.57,"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":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.65,"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":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.55,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.34,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.57,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.04,"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.1,"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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason 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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"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":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":233.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1015.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.46,"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":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"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":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.41,"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":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.37,"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":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.55,"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":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.57,"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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.3,"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.63,"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":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1595.03,"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":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.99,"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":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":23.65,"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":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.01,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":134.66,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":92.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","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":[2]}]},{"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.95,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.75,"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":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-06","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.67,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.05,"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"]},{"negotiated_type":"negotiated","negotiated_rate":296.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.65,"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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.32,"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":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":50.36,"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.3,"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":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":972.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.68,"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":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":389.26,"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"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":118.06,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.02,"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":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.72,"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":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12084.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":9.97,"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":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"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":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2583.83,"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":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1569.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.38,"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":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.17,"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"]},{"negotiated_type":"negotiated","negotiated_rate":83.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.33,"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":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":85.5,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":107.95,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":61.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.78,"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":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13020","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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.39,"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":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.57,"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":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.72,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2761.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0130","name":"Noner transport wheelch van","description":"Non-emergency transportation: wheelchair van","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TP"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.9,"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80359","name":"Methylenedioxyamphetamines","description":"Methylenedioxyamphetamines (mda, mdea, mdma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.78,"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"]},{"negotiated_type":"negotiated","negotiated_rate":107.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.69,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81509","name":"Ftl cgen abnor 3 proteins","description":"Fetal congenital abnormalities, biochemical assays of three proteins (papp-a, hcg [any form], dia), utilizing maternal serum, algorithm reported as a risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.37,"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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":65.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.74,"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":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.6,"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":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","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":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":175.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.81,"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","locality":"1320201","zip":"10001","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":["UE","KE","NU","RR","KU"]}],"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":621.03,"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":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":61.89,"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":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1829.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":174.63,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":175.74,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.58,"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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.37,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":358.45,"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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.46,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81357","name":"U2af1 gene common variants","description":"U2af1 (u2 small nuclear rna auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, s34f, s34y, q157r, q157p)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.75,"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":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["QW"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.98,"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":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4588.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":88.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":176.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"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":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"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":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":37.95,"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":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.21,"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":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":16.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a 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 pri","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.21,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10985","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":216.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80177","name":"Drug scrn quan levetiracetam","description":"Levetiracetam","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.75,"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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.25,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.31,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.28,"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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":4717.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.4,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.79,"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"]},{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.69,"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":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.33,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.41,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.53,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.53,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.3,"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":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":356.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":200.65,"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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3654.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.16,"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"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.6,"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.16,"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"]},{"negotiated_type":"negotiated","negotiated_rate":155.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.18,"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":80.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.88,"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":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.6,"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":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.81,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.8,"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":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.16,"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":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.4,"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":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":102.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.29,"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":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.84,"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":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 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 cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80151","name":"Drug assay amiodarone","description":"Amiodarone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.95,"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":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"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":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"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":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.45,"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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":["26"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.35,"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":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.14,"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":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.16,"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":"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.72,"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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.61,"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":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80230","name":"Drug assay infliximab","description":"Infliximab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.71,"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":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5952.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.88,"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"]},{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":33.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"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":312.64,"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":"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":"percentage","negotiated_rate":20.0,"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":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":417.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":327.65,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.16,"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":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.58,"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.4,"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":153.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"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":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.38,"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":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.6,"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":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":70.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"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":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3219.57,"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":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":278.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"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":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":3.28,"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":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.41,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":139.23,"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"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":106.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"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":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","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"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.52,"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"]},{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.78,"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":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.45,"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":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"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":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.37,"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":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":416.91,"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":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10047","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":["26","TC"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.13,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","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":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":181.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.05,"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":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno 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":"percentage","negotiated_rate":20.0,"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":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.97,"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":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.36,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"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":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.45,"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":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.99,"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":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.67,"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"]}],"provider_references":[2]}]},{"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","zip":"13020","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.88,"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":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0110","name":"Nonemergency transport bus","description":"Non-emergency transportation and bus, intra or inter state carrier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"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":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U5"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","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":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.01,"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":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":341.36,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.05,"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":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"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":1232.99,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.37,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.43,"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":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":310.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.02,"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":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.56,"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":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"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":"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":"10910","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.4,"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":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.98,"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":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"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":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.03,"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":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), 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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.3,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3850.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":144.88,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.28,"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":"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.98,"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":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.08,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.57,"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":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"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"]},{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.66,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.68,"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.62,"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":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1318.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1792.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":165.2,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.16,"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.63,"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":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"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":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"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":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320203","zip":"10512","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":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":65.9,"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":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.9,"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.13,"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":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.79,"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":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.9,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1958.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.0,"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":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":99.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"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"]},{"negotiated_type":"negotiated","negotiated_rate":74.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.89,"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"]},{"negotiated_type":"negotiated","negotiated_rate":33.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"63053","name":"Lam factc/frmt arthrd lum ea","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; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"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":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.84,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":276.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.73,"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":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.89,"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":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AX"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2195.42,"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":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.35,"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"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":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.79,"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":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.1,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"13143","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":284.52,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2727.0,"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":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":243.87,"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":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.18,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1309.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":325.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.08,"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":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.58,"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"]},{"negotiated_type":"negotiated","negotiated_rate":401.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.19,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.04,"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":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3343.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.08,"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":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80345","name":"Drug screening barbiturates","description":"Barbiturates","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.95,"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"]},{"negotiated_type":"negotiated","negotiated_rate":371.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":84.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.77,"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"]},{"negotiated_type":"negotiated","negotiated_rate":151.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":61.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.76,"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":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"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":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","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":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.42,"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":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.52,"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":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3386.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.29,"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":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.26,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.76,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"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":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; 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":"percentage","negotiated_rate":20.0,"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":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"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":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.69,"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"]},{"negotiated_type":"negotiated","negotiated_rate":61.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"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":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":225.74,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.6,"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"]}],"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":151.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":177.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"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":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.2,"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":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.06,"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":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.21,"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":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.65,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.46,"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":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.52,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.93,"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":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":31.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":477.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.6,"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":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.76,"expiration_date":"9999-12-31","billing_class":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.15,"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":"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.65,"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":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.3,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"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","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2948.5,"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1175.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.88,"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":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"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":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.8,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":271.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":65.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.06,"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"]},{"negotiated_type":"negotiated","negotiated_rate":199.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high 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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.78,"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":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.34,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.45,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.94,"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":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.41,"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":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10047","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.9,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.47,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.43,"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":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.23,"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":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.56,"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":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"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":"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.21,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.21,"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"]},{"negotiated_type":"negotiated","negotiated_rate":17.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous 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":"percentage","negotiated_rate":20.0,"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":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.49,"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":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2475.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":40.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":7.58,"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":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.89,"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":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":1433.19,"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":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.6,"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.03,"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":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.95,"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":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.5,"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":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":190.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","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"]}],"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":122.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13827.39,"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":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.86,"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":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1847.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"percentage","negotiated_rate":20.0,"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":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":56.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":13.58,"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":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"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":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.24,"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":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.82,"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":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.97,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80181","name":"Drug assay flecainide","description":"Flecainide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"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":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.93,"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":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":172.2,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":222.68,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":72.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":261.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":147.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.24,"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":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":129.58,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.15,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4457.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.06,"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":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2342.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.73,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":216.76,"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"]},{"negotiated_type":"negotiated","negotiated_rate":340.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.28,"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":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","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":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.41,"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":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80356","name":"Heroin metabolite","description":"Heroin metabolite","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":158.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.5,"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":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.94,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.97,"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":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","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":[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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.68,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2680.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.36,"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":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.39,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":206.46,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":151.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":177.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81193","name":"Ntrk3 translocation analysis","description":"Ntrk3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.95,"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":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"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":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.3,"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":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"13143","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92938","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.73,"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":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"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":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"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":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"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"]},{"negotiated_type":"negotiated","negotiated_rate":134.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.29,"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":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"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":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80285","name":"Drug assay voriconazole","description":"Voriconazole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.97,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.05,"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":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.66,"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":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.24,"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.73,"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":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.83,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.51,"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":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.46,"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":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"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":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"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":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.33,"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"]},{"negotiated_type":"negotiated","negotiated_rate":170.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.53,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"percentage","negotiated_rate":20.0,"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":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.12,"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":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80323","name":"Alkaloids nos","description":"Alkaloids, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.71,"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":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","zip":"14001","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"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2518.25,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":208.26,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.67,"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":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","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":[2]}]},{"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":1915.15,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"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":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.5,"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":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.51,"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":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"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":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":6.34,"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":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.96,"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":"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":123.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":205.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2973.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":254.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.56,"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":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.83,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":429.13,"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"]}],"provider_references":[4]}]},{"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":"10047","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.2,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81288","name":"Mlh1 gene","description":"Mlh1 (mutl homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; promoter methylation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.41,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.13,"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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.79,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.02,"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"]},{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":8.61,"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":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.12,"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":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.84,"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":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.97,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S5560","name":"Insulin reuse pen 1.5 ml","description":"Insulin delivery device, reusable pen; 1.5 ml size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 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); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.74,"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":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.29,"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":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.53,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10047","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":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.78,"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":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.95,"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":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.32,"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"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.84,"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":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.23,"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":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":860.87,"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":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.45,"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"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":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.5,"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":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.2,"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"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":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.28,"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":"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.51,"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":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":52.89,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.58,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.07,"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":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":208.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":163.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.04,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.31,"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":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. 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":"percentage","negotiated_rate":20.0,"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":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":133.79,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":126.77,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.39,"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.63,"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":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.75,"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":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2578.02,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":187.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"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":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","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"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.93,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.9,"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"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":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"percentage","negotiated_rate":20.0,"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":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.81,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":225.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.81,"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":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["QW"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.32,"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"]},{"negotiated_type":"negotiated","negotiated_rate":593.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.64,"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":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":91.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.66,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":78.24,"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":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.41,"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"]},{"negotiated_type":"negotiated","negotiated_rate":42.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.78,"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":"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2236.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.63,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.04,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.9,"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":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":14.28,"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"]},{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.57,"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":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.56,"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":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":105.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.67,"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":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.04,"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":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.3,"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":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.92,"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"]},{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":49.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.98,"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":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"percentage","negotiated_rate":20.0,"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":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3555.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":453.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":149.03,"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":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.32,"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":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","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":"81218","name":"Cebpa gene full sequence","description":"Cebpa (ccaat/enhancer binding protein [c/ebp], alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.72,"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":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":26.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":104.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.08,"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"]},{"negotiated_type":"negotiated","negotiated_rate":2402.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.25,"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"]},{"negotiated_type":"negotiated","negotiated_rate":185.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1887.11,"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":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.46,"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":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.01,"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":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":878.06,"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":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10301","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":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.58,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.14,"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":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":321.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":182.15,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":80.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.3,"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":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":123.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"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":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, 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 evaluation and management service provided within the p","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.34,"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":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4891.13,"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":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.16,"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":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.98,"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":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":33.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":318.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.34,"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":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.01,"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":"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":"1329204","zip":"11004","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"]},{"negotiated_type":"negotiated","negotiated_rate":83.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.78,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.55,"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"]},{"negotiated_type":"negotiated","negotiated_rate":252.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.8,"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":"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.68,"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":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.38,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1161.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.87,"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"]},{"negotiated_type":"negotiated","negotiated_rate":190.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"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":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.93,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.91,"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":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.12,"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"]},{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90611","name":"Smallpox&monkeypox vac 0.5ml","description":"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 ml dosage, suspension, for subcutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"14001","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"]}],"provider_references":[5]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"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":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.84,"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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.99,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.1,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1438.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2679.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.52,"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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":180.82,"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"]}],"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":75.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":141.89,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 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":"percentage","negotiated_rate":20.0,"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":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.29,"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":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.97,"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":"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":150.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.75,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.85,"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":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2408.51,"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":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.41,"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":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1365.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1688.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.43,"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":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"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":"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0170","name":"Transport parking fees/tolls","description":"Transportation ancillary: parking fees, tolls, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.29,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":["TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.2,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"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":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80348","name":"Drug screening buprenorphine","description":"Buprenorphine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation 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 vr procedural dissociation supports; each additiona","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"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":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":222.68,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80362","name":"Opioids & opiate analogs 1/2","description":"Opioids and opiate analogs; 1 or 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","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":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","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":[2]}]},{"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":"1329204","zip":"11004","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":["TC"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.23,"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":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.61,"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":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10910","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":107.91,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.06,"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":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.7,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":964.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.32,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":203.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.42,"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":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.09,"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":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.3,"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":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.56,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1531.88,"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":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"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":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.23,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9012","name":"Other specified case mgmt","description":"Other specified case management service not elsewhere classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.78,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.77,"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":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2217.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.03,"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"]},{"negotiated_type":"negotiated","negotiated_rate":142.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.31,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.69,"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":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.37,"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"]},{"negotiated_type":"negotiated","negotiated_rate":181.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":66.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.89,"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.35,"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":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.51,"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":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.56,"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":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.52,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","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":["NU"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.27,"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":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87662","name":"Zika virus dna/rna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); zika virus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.73,"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":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.41,"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":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.05,"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":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.96,"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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.8,"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"]},{"negotiated_type":"negotiated","negotiated_rate":1175.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1328299","zip":"12007","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.39,"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":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.73,"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":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80335","name":"Antidepressant tricyclic 1/2","description":"Antidepressants, tricyclic and other cyclicals; 1 or 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.86,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.11,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":47.12,"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":"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.57,"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":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.37,"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":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.43,"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":"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.88,"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":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.9,"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":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97151","name":"Bhv id assmt by phys/qhp","description":"Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physicians or other qualified health care professionals time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":109.03,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":223.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80320","name":"Drug screen quantalcohols","description":"Alcohols","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.13,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1502.65,"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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"10910","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":[2]}]},{"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":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.86,"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"]},{"negotiated_type":"negotiated","negotiated_rate":271.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-06","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.26,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.82,"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":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b 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]) and influenza virus types a and b","date_of_service":"2026-06-06","zip":"14001","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":["QW"]}],"provider_references":[5]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.71,"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.52,"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":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, 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 elements: tracking ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.67,"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":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.01,"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"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":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.84,"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":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":1.73,"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"]},{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.26,"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":74.77,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.26,"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":"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":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.37,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"14001","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":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":164.67,"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"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.72,"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":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.94,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.01,"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":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.19,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":119.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.17,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":314.87,"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":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2515.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14747.21,"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":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":129.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","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":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10985","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":[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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.72,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":235.59,"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"]},{"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":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.28,"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":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high 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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.09,"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":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","zip":"10501","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"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-06","zip":"10047","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.87,"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":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 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 respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"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":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4361.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.58,"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":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.51,"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":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.75,"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"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.04,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.18,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video 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 or e","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.27,"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"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":673.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81347","name":"Sf3b1 gene common variants","description":"Sf3b1 (splicing factor [3b] subunit b1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, a672t, e622d, l833f, r625c, r625l)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.14,"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":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.76,"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":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.16,"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":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.98,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","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":[2]}]},{"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":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":57.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":111.06,"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":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"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":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["MS"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.67,"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"]},{"negotiated_type":"negotiated","negotiated_rate":148.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), 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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.21,"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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.08,"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":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.94,"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":184.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":62.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"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":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface 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","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-06","zip":"13020","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.58,"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":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.82,"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":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5119.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":416.39,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4063.94,"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"13143","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.15,"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":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":171.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.42,"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":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.69,"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":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.15,"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":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.83,"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":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.28,"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":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.15,"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":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.77,"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":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.08,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":40.5,"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":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-06","zip":"13020","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":[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","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":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.02,"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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"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"]},{"negotiated_type":"negotiated","negotiated_rate":68.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1015.37,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.89,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.4,"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":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.93,"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":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.77,"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":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","zip":"10047","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.99,"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":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.55,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.52,"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.57,"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":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.74,"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"]},{"negotiated_type":"negotiated","negotiated_rate":273.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320201","zip":"10001","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"]},{"negotiated_type":"negotiated","negotiated_rate":30.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.45,"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":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.54,"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"]},{"negotiated_type":"negotiated","negotiated_rate":934.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.34,"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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"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":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":118.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.82,"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"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.09,"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":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.71,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"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":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1328299","zip":"12007","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.23,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.42,"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":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.88,"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":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","zip":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"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":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.52,"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":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.74,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.2,"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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.02,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.4,"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":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","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":[2]}]},{"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":"14001","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":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.9,"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":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.17,"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":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.83,"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"]}],"provider_references":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.91,"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":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10910","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.69,"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.34,"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":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.84,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["KE","RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.91,"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":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-06","zip":"13143","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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.02,"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":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7836.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.54,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.5,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2540.23,"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":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.17,"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":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","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":[2]}]},{"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","zip":"10501","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":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.89,"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":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.25,"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":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.13,"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.55,"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":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.64,"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":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.27,"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":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.17,"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"]},{"negotiated_type":"negotiated","negotiated_rate":132.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.05,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.45,"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":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.61,"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":"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":67.83,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.6,"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":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.69,"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":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.71,"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"]},{"negotiated_type":"negotiated","negotiated_rate":143.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":208.81,"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.2,"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":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1328299","zip":"12007","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3526.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":199.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.88,"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":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.52,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":355.81,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.37,"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":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.11,"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":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.01,"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":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3345.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":239.45,"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"]},{"negotiated_type":"negotiated","negotiated_rate":141.0,"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":"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2025","name":"Supp maint employ, 15 min","description":"Ongoing support to maintain employment, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GT","HE","FQ"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.61,"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"]},{"negotiated_type":"negotiated","negotiated_rate":169.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.97,"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":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.88,"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":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.54,"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.34,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.25,"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":106.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":124.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":95.6,"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"]},{"negotiated_type":"negotiated","negotiated_rate":159.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","zip":"10501","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":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.43,"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":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.25,"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":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.85,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.27,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.91,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"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":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"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":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3735.3,"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":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.14,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.31,"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"]},{"negotiated_type":"negotiated","negotiated_rate":101.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":1007.37,"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":129.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.84,"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":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":164.67,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.21,"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":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.25,"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":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.43,"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":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13143","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"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":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.55,"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":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.54,"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":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.8,"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":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.71,"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":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.88,"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":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.82,"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":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":109.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.0,"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":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3318.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"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":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.06,"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":113.28,"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":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.1,"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":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4375.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.88,"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":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.23,"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":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.61,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81246","name":"Flt3 gene analysis","description":"Flt3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (tkd) variants (eg, d835, i836)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.37,"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":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.26,"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":18.4,"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":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q3014","name":"Telehealth facility fee","description":"Telehealth originating site facility fee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["HB"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":290.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.68,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.97,"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":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.21,"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":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2583.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"13143","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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":117.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":103.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0002","name":"Alcohol and/or drug screenin","description":"Behavioral health screening to determine eligibility for admission to treatment program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GT","HE","FQ"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"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":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.32,"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":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.65,"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":"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":"10047","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.79,"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":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.0,"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":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"13143","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":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10501","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":[6]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":177.94,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.75,"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":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.97,"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.66,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0683T","name":"Prgrmg dev eval isdss 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, permanent implantable synchroni","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1176.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.63,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.15,"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":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.32,"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":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.46,"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"]},{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"10301","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":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A0430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4358.94,"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":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"13020","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":["QW"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28291","name":"Corrj halux rigdus w/implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1320201","zip":"10001","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":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.77,"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":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.71,"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":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"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":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"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":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.43,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss 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, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"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"]},{"negotiated_type":"negotiated","negotiated_rate":165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.9,"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":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.64,"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":"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.8,"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":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.45,"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":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77387","name":"Guidance for radj tx dlvr","description":"Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.1,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.69,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.43,"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":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":926.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), 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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.35,"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":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.83,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [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/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":371.57,"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","zip":"13143","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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","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":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"10011","name":"Fna bx w/mr gdn 1st les","description":"Fine needle aspiration biopsy, including mr guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.66,"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":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.61,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97155","name":"Adapt behavior tx phys/qhp","description":"Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.04,"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":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.15,"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":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.57,"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":4.51,"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":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.49,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":98.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.69,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.77,"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":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","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":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.09,"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":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-06","zip":"10301","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":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.25,"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":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.61,"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":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"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"]},{"negotiated_type":"negotiated","negotiated_rate":29.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"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":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.07,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":127.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":248.44,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.76,"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":"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":"14001","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":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["NU"]},{"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-06","zip":"10910","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.65,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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":"1328299","zip":"12007","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":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81351","name":"Tp53 gene full gene sequence","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"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":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.29,"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":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-06","zip":"10910","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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"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":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.56,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.91,"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"]},{"negotiated_type":"negotiated","negotiated_rate":114.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.28,"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":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.65,"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":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","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"]},{"negotiated_type":"negotiated","negotiated_rate":51.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1349.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.52,"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":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.52,"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":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.61,"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":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.74,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.37,"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":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.83,"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":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.44,"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":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.49,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of 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 radi","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2025.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.3,"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":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"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":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":41.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"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","zip":"10910","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"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.67,"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":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.81,"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":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.64,"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":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"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":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10047","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0100","name":"Nonemergency transport taxi","description":"Non-emergency transportation; taxi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TF"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","zip":"10910","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-06","zip":"10985","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":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.9,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.31,"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":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.69,"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"]},{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"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":"1320203","zip":"10512","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"]},{"negotiated_type":"negotiated","negotiated_rate":34.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.24,"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":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.44,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.53,"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":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","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":[3]}]},{"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","zip":"10301","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":[7]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":74.51,"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":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.19,"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.93,"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":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","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"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"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":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":197.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, 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 elements: outrea","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, 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 applicable validated rating scales, behavioral he","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10910","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","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":[2]}]},{"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":"14001","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":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"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"]},{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.68,"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":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.3,"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":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.73,"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":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.54,"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":"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":"percentage","negotiated_rate":20.0,"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":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1052.73,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.98,"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":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification 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; each additional 15 minutes","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.19,"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"]},{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-06","zip":"13020","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.17,"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.12,"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":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.25,"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":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"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":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.84,"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":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"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"]},{"negotiated_type":"negotiated","negotiated_rate":226.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8329.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.31,"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":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for 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 (list separately in addition to code for primary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":131.09,"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"]}],"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for 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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient 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/decompensation, or functional decline, provided by c","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2574.85,"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":"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","zip":"10501","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":[6]}]},{"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":"1320203","zip":"10512","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":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.56,"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":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.65,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr 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, leadless pacemaker system in si","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1837.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.29,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320203","zip":"10512","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":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"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":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.98,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90622","name":"Vaccinia vrs vac 0.3 ml perq","description":"Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 ml dosage, for percutaneous use","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for 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","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.37,"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":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"percentage","negotiated_rate":20.0,"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":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","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":[2]}]},{"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.76,"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":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.03,"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":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.29,"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":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"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":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious 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), quantitative","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.28,"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":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","zip":"10501","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":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","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":[2]}]},{"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":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.74,"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":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10238.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.21,"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":6.15,"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":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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"]},{"negotiated_type":"negotiated","negotiated_rate":62.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.98,"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":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.8,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.68,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4249.58,"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":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire 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":"percentage","negotiated_rate":20.0,"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":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.12,"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":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.31,"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":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"13020","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.55,"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":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"13143","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":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.35,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.67,"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"]},{"negotiated_type":"negotiated","negotiated_rate":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","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":[2]}]},{"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","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"1320201","zip":"10001","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":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-06","zip":"10985","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":["26","TC"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.69,"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":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.73,"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"]},{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.74,"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":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"1320201","zip":"10001","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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.01,"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"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","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":[2]}]},{"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":"1320201","zip":"10001","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":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.24,"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":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"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","zip":"10985","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":["26","TC"]}],"provider_references":[3]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.34,"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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":118.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-06","zip":"13143","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","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, 2-15 days in a 30-day period","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.3,"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"]},{"negotiated_type":"negotiated","negotiated_rate":239.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","zip":"10985","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"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","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; combined ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"]},{"negotiated_type":"negotiated","negotiated_rate":332.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[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","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80165","name":"Dipropylacetic acid free","description":"Valproic acid (dipropylacetic acid); free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"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":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"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":"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"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":"10501","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":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for 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":"1320201","zip":"10001","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":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for 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; initial 30 minutes","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"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","zip":"10301","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"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-06","zip":"10985","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-06","zip":"10047","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":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-06","zip":"10047","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.38,"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":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 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 10 minutes","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate 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","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-06","zip":"13020","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","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":[3]}]},{"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1931.29,"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":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","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":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-06","zip":"13143","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":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-06","zip":"10910","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":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-06","zip":"14001","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":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["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":[2]}]},{"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":"1329204","zip":"11004","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":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":["26","TC"]}],"provider_references":[2]}]},{"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","zip":"10910","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":[2]}]}]}
